Factors influencing stress, anxiety, and depression among Iranian pregnant women: the role of sexual distress and genital self-image

Afsaneh Keramat,Nastaran Bagherian,Mahmood Moosazadeh,Mina Malary,Mohammad-Reza Rajabi-Shakib

doi:10.1186/s12884-021-03575-1

Abstract

BackgroundPregnancy is a unique period with the increased likelihood of psychological changes and emotional disturbances such as depression, anxiety, and stress. In this study, we investigated the factors influencing depression, anxiety, and stress in pregnancy and identify their associations with Sexual Distress (SD) and Genital Self-Image (GSI).MethodsThis was a descriptive, correlational, cross-sectional study performed using the two-stage cluster sampling method between September 2019 and January 2020. Overall, 295 pregnant women completed a demographics and obstetric information checklist, Depression Anxiety and Stress Scale-21 (DASS-21), Female Genital Self-Image Scale (FGSI), and Female Sexual Distress Scale-Revised (FSDS-R).ResultsAnalysis of Variance (ANOVA) showed significant differences in the mean scores of SD between the groups with varying degrees of depression, anxiety, and stress (P < 0.001) and in the mean score of GSI between the groups with varying degrees of depression (P = 0.01) and anxiety (P < 0.001). In multivariate linear regression analysis, higher (worse) depression, anxiety, and stress scores were found in women with more advanced age and higher SD scores; however, these scores were lower (better) in those with increased gestational age. Lower depression and anxiety scores were associated with moderate satisfaction with income, moderate satisfaction with BI in pregnancy, and lower stress and depression scores were linked to planned pregnancy. Higher (better) GSI score was a predictor of lower depression score, complication in a previous pregnancy was a predictor of higher stress score, and finally, fear of fetal abortion and being a housewife were predictors of a higher anxiety score.ConclusionVarious factors contribute to the development of antenatal depression, anxiety, and stress. A positive correlation was found between SD and the severity of depression, anxiety, and stress, while a negative correlation was noted between GSI and the severity of depression and anxiety. Therefore, raising awareness regarding SD and GSI through screening and counseling sessions can have beneficial effects for mothers and their fetuses.

Highlights

Pregnancy is a unique period with the increased likelihood of psychological changes and emotional disturbances such as depression, anxiety, and stress
The present study demonstrated that female Sexual Distress (SD) was a significant factor contributing to depression, anxiety, Table 2 Descriptive statistics for all participant characteristics (n = 295)
We found that women with higher Genital Self-Image (GSI) score were at a lower risk for depression in multivariate linear regression analysis

Summary

Introduction

Pregnancy is a unique period with the increased likelihood of psychological changes and emotional disturbances such as depression, anxiety, and stress. Pregnancy is one of the most critical periods with considerable changes in women’s physical, mental, and sexual states [1]. During this period, vulnerability to emotional and psychological conditions such as depression, anxiety, stress, and psychosis is increased, which can lead to maternal and fetal adverse consequences [2]. The prevalence rates of prenatal stress, anxiety, and depression during the first weeks of pregnancy were reported 91.86, 15.04 and 5.19%, respectively [5]. The combination of maternal depression, stress, and anxiety can cause preterm labor, preeclampsia, and fetal neurodevelopmental problems [7]

Methods

Results

Conclusion