The Relationship between Stress, Anxiety and Pain with Salivary Cortisol Levels in First Stage of Labor in Primiparous Women

In general population in response to fear, stress and anxiety stress-related hormones such as cortisol are changing. Labor is the most women's life event stressor. Over 90% of stress and anxiety during pregnancy is associated with birth process. The purpose of this study was to investigate the impact of stress, anxiety and pain in salivary cortisol levels in first stage of labor on primiparous women. This descriptive cross-sectional study was conducted on 80 primiparous pregnant women who referred to Ommol Banin hospital in Mashhad, Iran in 2012. In the first stage of labor with dilatation of 7-5 cm visual analog scale of stress and pain and Spielberger anxiety questionnaire were completed for all subjects and saliva samples were taken to measure cortisol levels. Data were analyzed by SPSS software (version 11.5). P value less than 0.05 was considered significant. There was a significant correlation between salivary cortisol levels and mean levels of maternal stress on the visual scale (p=0.005) but the Pearson correlation test was not significant between mean salivary cortisol levels and mean levels of anxiety (p=0.173) and pain (p=0.581). Labor as the most stressful women’s physical and mental event affect on women’s physiological and psychological parameters during labor. Thus, stress during labor affect on cortisol index as an indicator of hypothalamic - pituitary axis activity and autonomic nervous system.