Allostasis: a theoretical framework for understanding and evaluating perinatal health outcomes.

OBJECTIVE: To explore the theory of allostasis within the context of childbearing women's perceptions or experiences of stress and perinatal health outcomes. DATA SOURCES: Articles published in refereed journals and selected chapters from published books that addressed physiological and psychological effects of perceived or actual stress experiences, or both, including the theory of allostasis, on health outcomes. STUDY SELECTION: Qualitative, quantitative, and review articles that focused on psychoneurohormonal responses to physical and psychological stress in pregnant and nonpregnant human cohorts and the theory of allostasis. DATA EXTRACTION AND SYNTHESIS: The impact of abnormal allostatic states in childbearing women in response to physiological and psychological perceptions or experiences of stress, or both was analyzed. There is a growing body of epidemiologic evidence to support the relationship between maternal stress and adverse pregnancy outcomes.
CONCLUSIONS: The theory of allostasis provides a framework for understanding and evaluating the complex elements of stress, coping, and adaptation during childbearing on perinatal health outcomes and has the potential to provide new insight into previously unexplained adverse perinatal events.