Pregnancy Stress Rating Scale Research Articles

Perceived stress and its associated factors among pregnant women attending antenatal clinic in a tertiary level hospital

Background: Stress has been found widely prevalent among women during the time of pregnancy. Researches in different societies indicate a link between prenatal maternal stress and adverse obstetric, fetal, and neonatal outcome. Therefore, this study was carried out to assess perceived stress levels and associated factors with it among pregnant women.Methods: A descriptive cross-sectional study was carried out from November 2022 to March 2023 among 264 pregnant women attending the Obstetrics/Gynaecology outpatient department of Nepal Medical College and Teaching Hospital. Pregnancy Stress Rating Scale (PSRS) was adopted to measure perceived stress levels among pregnant women. Data were collected through face-to-face interview techniques. Descriptive statistics and logistic regression analysis were used for data analysis.Results: In this study, 11.4% (95% CI= 7.8% - 15.8%) of pregnant women had high levels of stress. Variables such as ethnicity, education of respondents and respondents’ husbands, status of pregnancy (pregnancy intention), and gender preference were associated with high levels of perceived stress in bivariate analysis. While, only those respondents having male gender preference for the upcoming baby was associated with a high level of stress (AOR= 3.07; 95% CI = 1.26 –7.48) in multivariate analysis.Conclusions: Approximately one out of nine pregnant women had a high level of stress in this study. Respondent’s gender preference for male babies was associated with high levels of stress in multivariate analysis. Therefore, early recognition of antenatal stress and its management is crucial.

Factors associated with stress among pregnant women with a second child in Hunan province under China’s two-child policy: a mixed-method study

ObjectiveThe purpose of the study was to investigate the status of pregnancy stress and to explore factors associated with pregnancy stress among women by China’s two-child policy.MethodsA mixed-method study involving both quantitative and qualitative methods was conducted using questionnaires and semi-structured interviews. The questionnaires encompassed socio-demographic and obstetric characteristics, as well as the Pregnancy Stress Rating Scale (PSRS) and the Social Support Rating Scale (SSRS). Initially, the participants were required to complete the questionnaires, enabling us to assess their respective pregnancy stress statuses. Subsequently, we selectively interviewed pregnant women with a second child and exhibited at least mild pregnancy stress. The qualitative study sought to uncover the factors contributing to their stress during pregnancy.ResultsA total of 463 subjects were enrolled; of the subjects, 22 (4.8%) had no stress, 407 (87.9%) had mild stress, 34 (7.3%) had moderate stress. Generalized linear regression analysis revealed significant factors (P<0.05) related to pregnancy stress, including family financial burden, subjective support, fertility desire, gender of the first child, and gender preference. Additionally, 16 subjects were interviewed, and through analysis, three major themes emerged, each comprising 12 sub-themes associated with pregnancy stress. These themes were identified as fertility factors (worry about maternal and child health, birth experience, and parenting stress), family factors ( financial burden, second child care problems, first child’s acceptance of the second child, family concerns, fertility desire, and gender preference) and social factors (involving life events, career development and workload).ConclusionThe diver factors contribute to pregnancy stress among pregnant women under China’s two-child policy. Our study could be used to develop appropriate interventions to reduce pregnancy stress and to enhance the mental health of women pregnant with a second child.

The effect of pregnant women's status of receiving preconception care on pregnancy stress.

In the study, we aimed to determine the effect of pregnant women's status of receiving preconception care on their pregnancy stress. This is a descriptive, correlational, and cross-sectional design study, we were conducted with the participation of 409 pregnant women between June-December 2019. The Pregnancy Stress Rating Scale total score mean was found to be 30.72 ± 20.26. Individuals who received medication and vitamins as part of preconceptional care had significantly higher scores (p < 0.05; p < 0.001) compared to those who did not receive them for total pregnancy stress, postpartum social support, infant health, and infant identity-care stress. Similarly, individuals who received medical treatment and regular checkups had significantly higher scores (p < 0.05) compared to those who did not for total pregnancy stress, postpartum social support, infant identity-care, body image and psychological state during pregnancy stress scores. In addition, individuals who maintained a healthy lifestyle had significantly higher scores (p < 0.05; p < 0.001) compared to others for infant health, infant identity-care, and psychological distress during pregnancy. It was determined that women who made preparations for their pregnancy experienced more stress related to their babies (baby's health, baby's identity and care), psychological status in pregnancy, prenatal and postnatal social support, and body image.

The Relationship Between Spousal Support and Pregnancy Stress in High-Risk Pregnant Women

Objective: This research was conducted to establish the relationship between spousal support and pregnancy stress in high-risk pregnant women. Methods: The sample of the descriptive and correlational study consisted of 220 pregnant women who were hospitalized for treatment in the perinatology service of the Women’s and Children’s Hospital on the Anatolian side of Istanbul between 1st December 2020 and 1st February 2021. Data were collected using a descriptive data collection form, the Pregnancy Stress Assessment Scale, and the Spousal Support Scale. Data analysis involved numerical and percentage calculations, ANOVA test, Kruskal Wallis test, t-test, and Spearman correlation analysis. Results: The average score on the Pregnancy Stress Assessment Scale for the participating pregnant women was 50.24 ± 27.10, and the average score on the Spousal support scale was 57.69 ± 9.21. No statistically significant relationship was found between the average scores on the Pregnancy Stress Rating Scale and the Spousal Support Scale for pregnant women (P &gt; 0.01). Conclusion: It is recommended that nurses and midwives working with high-risk pregnant women incorporate plans to reduce pregnancy stress into their care processes.

Predictors of pregnancy stress and psychological birth trauma in women undergoing vaginal delivery: a cross-sectional study in China

BackgroundPsychological birth trauma exhibits a high incidence worldwide, resulting in a wide range of negative impacts on mothers, infants, couples, families and society at large through the maternal-centered ripple effect. However, there is currently limited research on psychological birth trauma in China. Social support and pregnancy stress are important influencing factors of psychological birth trauma. Consequently, this study aimed to explore predictors of pregnancy stress and psychological birth trauma in women undergoing vaginal delivery in China.MethodsThis cross-sectional study was performed at a single medical center between December 2021 and May 2022 in Hangzhou, China. Participants were selected using a convenience sampling technique. A total of 351 postpartum women within one week after vaginal delivery were included. Questionnaires were used to collect sociodemographic and obstetric characteristics and scores on the Pregnancy Stress Rating Scale (PSRS), City Birth Trauma Scale (City BiTS), Social Support Rating Scale (SSRS) and Family Adaptation Partnership Growth Affection and Resolve index (Family APGAR). Both univariate analysis and multiple linear regression analysis were conducted to assess predictors of pregnancy stress and psychological birth trauma.ResultsThe median (IQR) of PSRS and City BiTS scores were 10.00 (14.00) and 3.00 (9.00), respectively. The incidence of postpartum posttraumatic stress disorder was 4.0% (14/351). Parity, social support, family support and level of education were predictors of pregnancy stress. Delivery complications, psychological traumatic event, pregnancy stress and family support were predictors of psychological birth trauma (P < 0.05).ConclusionPregnancy stress is related to social support, family support and some sociodemographic and obstetric characteristics. Psychological birth trauma is correlated with delivery complications, psychological traumatic event, pregnancy stress and family support. Consequently, enhancing social support, especially family support, for pregnant women as a means of reducing pregnancy stress can effectively prevent psychological birth trauma.

The Effect of Fear of COVID-19 on Prenatal Attachment and Pregnancy Stress in Pregnant Women

The coronavirus disease (COVID-19) pandemic has disrupted the lives of people around the world, causing illness, death, fear, and trauma. This study aims to determine the effect of fear of contracting COVID-19 on pregnancy stress and prenatal attachment in pregnant women. This cross-sectional and descriptive study was conducted with 270 pregnant women who were registered in the family health center of a city located in the eastern part of Turkey. Data were collected between November 2020 and March 2021. The average age of the participants was 28.24 ± 5.69. A positive and weak correlation was found between the Fear of COVID-19 Scale Mean score and the Prenatal Attachment Inventory (PAI) and Pregnancy Stress Rating Scale (PSRS) mean scores ( r = 0.379, 0.478; P &lt; 0.001, respectively). In addition, a weak correlation was detected between the PAI mean score and the PSRS mean score ( r = 0.495; P &lt; 0.001). Results showed that the fear of COVID-19 affected prenatal attachment at a proportion of 14% and pregnancy stress at a proportion of 22%. This study found that the fear of COVID-19 had effects on pregnancy stress and prenatal attachment. Healthcare professionals should consider the fear caused by the pandemic as a factor in the treatment-care and consultancy services provided to pregnant women in extraordinary, unprecedented times like the COVID-19 pandemic. [ Psychiatr Ann . 2023;53(8):381–388.]

Cognitive appraisal of health and its influencing factors among pregnant women with gestational diabetes mellitus: A cross‐sectional study

To investigate the status quo of cognitive appraisal of health and its influencing factors among pregnant women with gestational diabetes mellitus. A cross-sectional survey was conducted from June 2020 to November 2020. Participants were recruited from a tertiary hospital by a convenient sample method. A total of 300 pregnant women with gestational diabetes mellitus completed the survey, including self-compiled individual information questionnaire, Cognitive Appraisal of Health Scale, Pregnancy Stress Rating Scale and General Self-Efficacy Scale. For cognitive appraisal of health, the median score of challenge dimension was 3.75 (3.50, 4.00), benign/irrelevant was 2.75 (2.00, 3.50), harm/loss was 2.38 (2.00, 3.00) and threat was 2.40 (2.00, 2.80), respectively. Regression analyses showed that gestational age, mode of conception, history of abortion, insulin usage, pregnancy stress and self-efficacy were the predictors of cognitive appraisal of health. This study revealed that pregnant women with gestational diabetes mellitus tended to make positive cognitive appraisal of health. And healthcare providers need to make full use of their predictors of cognitive appraisal of health to improve cognitive appraisal to manage stress and ameliorate pregnancy outcomes.

Levels and Determinants of Antenatal Breastfeeding Attitudes among Pregnant Women: A Cross-Sectional Study

Breastfeeding attitudes are strong predictors of breastfeeding behavior. Gaining a deeper understanding on the levels and determinants of antenatal breastfeeding attitudes is crucial. This cross-sectional study involved 124 pregnant women at a tertiary hospital in Hunan, China. A self-administered questionnaire, the Iowa Infant Feeding Attitude Scale, the Edinburgh Postnatal Depression Scale, the Pregnancy Stress Rating Scale, the Childbirth Attitude Questionnaire, the Perceived Social Support Scale, and the Breastfeeding Knowledge Questionnaire were assessed during their first-trimester, second-trimester, and third-trimester hospital visit. Multiple linear regression was conducted to identify the determinants of breastfeeding attitudes. The participants reported neutral (56.39 ± 5.69) levels of breastfeeding attitudes. The determinants of antenatal breastfeeding attitudes were other family members' support for exclusive breastfeeding: moderate (β = 0.278, p < 0.05), depressive symptoms (β = -0.191, p < 0.05), and breastfeeding knowledge (β = 0.434, p < 0.001). The variables explained 33.9% (adjusted R2) of the total variation in breastfeeding attitudes scores (F = 4.507, p < 0.001). Namely, other family members' support for EBF was a negative influence on positive breastfeeding attitudes. The women whose other family members were moderate of EBF had more positive attitudes toward breastfeeding compared to those whose other family members were very supportive of EBF. The depressive symptoms were negatively associated with positive breastfeeding attitudes, and lower levels of depressive symptoms were associated with higher levels of positive breastfeeding attitudes among pregnant women. Additionally, breastfeeding knowledge was positively associated with positive breastfeeding attitudes. The more knowledgeable about breastfeeding, the more positive the attitude towards breastfeeding. Health professionals should identify these modifiable factors that may contribute to poorer breastfeeding attitudes, which is useful in targeting promotions of breastfeeding.

Pregnancy-Related Stress Among Pregnant Women Receiving Tocolytic and Non-Tocolytic Treatments Where Both Used Complementary Medicine.

Objective: This study aimed to compare the pregnancy stress among pregnant women in receiving tocolytic and non-tocolytic treatments where both used complementary medicine. Methods: A cross-sectional survey was conducted among 35 pregnant women receiving tocolytic treatment and 35 receiving non-tocolytic treatment, where both used complementary medicine in a medical center in central Taiwan. A basic information questionnaire that contained demographic variables and types of complementary medicine used and the Pregnancy Stress Rating Scale were used for the analysis. Results: The types of complementary medicines were surveyed using the multiple-choice questionnaire. Natural products (77.5%) were most commonly used by pregnant women receiving tocolytic treatment, followed by alternative medicine (13.75%), manipulative and body-based practices (5%), and mind and body medicine (3.75%). In pregnant women who were receiving non-tocolytic treatment, natural products (59.1%) were most commonly used, followed by manipulative and body-based practices (16.4%), alternative medicine (15.4%), mind and body medicine (7.3%), and energy therapy (1.8%). According to the analysis of covariance test results, while both used complementary medicine in groups, pregnant women receiving tocolytic treatment were less stressed than those who were receiving non-tocolytic treatment (Pregnancy Stress Rating Scale score, p = 0.038), especially in dimension 2 (stress caused by infant care and changes in family relationships) (p = 0.015) and dimension 5 (stress caused by changes in physical appearance and function) (p = 0.008), which showed statistically significant differences (p < 0.05). Linear regression analysis results showed that the gestational age significantly associated with pregnancy stress (Pregnancy Stress Rating Scale score, p = 0.029; dimension 2, p = 0.016; and dimension 5, p = 0.001). Conclusion: Among both who used complementary medicine, pregnancy stress was significantly lower in pregnant women who were receiving tocolytic treatment than in those who were receiving non-tocolytic treatment. This finding can be used as a reference for future pregnant women’s health studies.

Turkish Validity and Reliability Study of the Pregnancy Stress Rating Scale

Objective: This study was conducted to evaluate the reliability and validity by adapting to Turkish of the Pregnancy Stress Rating Scale (PSRS-36).Methods: The sample of this methodological study included 360 volunteer pregnant women. The data were collected with questionnaire form and Turkish version of the Pregnancy Stress Rating Scale. In data analysis were used Cronbach's alpha coefficient, explanatory, and confirmatory factor analysis (CFA) after the language and content validity of Pregnancy Stress Rating Scale. For CFA one of the concordance models of structural equality, LISREL, was used.Results: As a result of the explanatory factor analysis, it was found that the Pregnancy Stress Rating Scale had five sub dimensions structure as in the original form, and the factor loads of the model changed between 0.453-0.807. Cronbach's alpha coefficient of Turkish version of total Pregnancy Stress Rating Scale was 0.92. Cronbach’s alpha values of subdimensions of Pregnancy Stress Rating Scale. Turkish version was between 0.81 and 0.86. Of these x2/SD value 2.18, GFI 0.95, AGFI 0.94, CFI 0.95, RMSEA 0.077 and SRMR 0.075 were identified.Conclusion: The Turkish version of Pregnancy Stress Rating Scale (PSRS-36) was determined a valid and reliable measurement tool for Turkish society. The Turkish version of Pregnancy Stress Rating Scale (PSRS-36) be used as data collection tool to determine pregnancy stress by midwives and nurses.

EFFECTS OF STRESS IN PREGNANCY ON PRENATAL ATTACHMENT, AND CONTRIBUTING FACTORS

The mother's having good mental health during pregnancy is important for the mother's and fetus's health. Stress experienced during pregnancy can also affect prenatal attachment. In this study, it was aimed to determine the effect of the stress level of pregnant women on prenatal attachment and the factors affecting prenatal attachment. In this descriptive cross-sectional study conducted in the obstetrics outpatient clinic of a training and research hospital, 276 healthy primiparous pregnant women whose gestational age was ≥20 weeks were included. To collect the data, the Descriptive Characteristics Form, Pregnancy Stress Rating Scale (PSRS), and Prenatal Attachment Inventory (PAI) were used. The mean scores the participants obtained from the Pregnancy Stress Rating Scale and Prenatal Attachment Inventory were 40.13±31.22 and 46.87±16.62 respectively. A moderately statistically significant negative correlation was determined between pregnancy stress and prenatal attachment (r=-0.42, p=0.000). In the study, it was observed that pregnancy stress level of the participating pregnant women decreased as the age increased (r=-0.13, p=0.026), but that it increased as their education and income levels increased (χ2=8.150, p=0.043) - (χ2=6.785, p=0.034). The participants' attachment levels were not correlated with variables such as age, education, baby's sex and gestational age, but prenatal attachment levels of the participants who received social support while they did house hold chores were statistically significantly higher (U=7872.500, p=0.025). It was observed that as the prenatal attachment level of the participating pregnant women decreased, as their stress level increased, that their stress level decreased as their age increased, that that their stress level increased as the education and income levels increased, and that the prenatal attachment of the participants who received social support when they did household chores was higher. It is thought that health personnel can improve prenatal attachment by taking necessary steps to reduce the stress levels of pregnant women in this process.

COVID-19 Pandemic: Maternal Anxiety Increases During Pregnancy, Indonesia

Introduction: The anxiety of pregnant women during the Covid-19 pandemic increased compared to pregnancy in ordinary conditions because pregnant women are one of the populations vulnerable to Covid-19 infection. The Covid-19 Pandemic can affect the health of pregnant women and fetuses, even feared increased morbidity and mortality. This study aimed to determine the anxiety of pregnant women, especially related to maternal and infant health in the Covid-19 pandemic.Method: This research is using a quantitative descriptive method with a cross-sectional design. The sample in this study were all pregnant women who were willing to take part in this study. Respondents came from three islands in Indonesia, namely Java, Sulawesi and Sumatra. The sampling technique used accidental sampling; as many as 20 respondents carried out checks at health facilities during the pandemic Covid-19. Researchers adopted the Pregnancy Stress Rating Scale (PSRS) instrument for 36 items statement and converted it in a google form for online surveys. The data analysis in this study used a frequency distribution.Results: The results showed that most of the pregnant women who experienced a severe level of anxiety in “finding safe health facilities for mothers and babies during pregnancy, and childbirth” (32.3) with a tertiary level of education (71.4), live outside the island of Java (83.3), and anxiety increased in the second trimester (61.5) and the third trimester (66.7).Conclusion: The emotional well-being of pregnant women must be maintained to produce a good quality pregnancy outcome, so that health workers need to identify pregnant women's anxiety early to minimize its effects. In addition, pregnant women must have the self-awareness to assess the health conditions, including anxiety during the pregnancy process.

Psychological Resilience of Second-Pregnancy Women in China: A Cross-sectional Study of Influencing Factors

PurposeThe aim of the study was to evaluate the status of psychological resilience among women in their second pregnancy and to investigate the possible influencing factors. MethodsA total of 275 women in their second pregnancy and who met the criteria were surveyed from two public hospitals in China from July 2018 to January 2019. The instruments included the General Self-designed Questionnaire, Connor–Davidson Resilience Scale, Social Support Rate Scale, and 36-item Pregnancy Stress Rating Scale. ResultsThe total psychological resilience score of second-pregnancy women was relatively low. Multivariate regression analysis identified five factors associated with psychological resilience: intimacy with husbands, social support utilization, gender of the first child, high-risk pregnancy of the first child, and the stress caused by worrying about the health and safety of the mother and fetus. ConclusionWomen in their second pregnancy represent a unique population, and their low psychological resilience score deserves attention. Identification of factors contributing to decreased psychological resilience may enable us to design prevention and intervention strategies and to deliver specific psychological supports to pregnant women at high risk of developing negative psychology.

Stress and Coping Strategies among Pregnant Women attending Antenatal Clinic of a Teaching Hospital in eastern Nepal

Aim: To find out the stress and coping strategies among pregnant women attending antenatal clinic.&#x0D; Methods: A descriptive, cross-sectional research design was used for the study. The sample was taken from an antenatal outpatient department of Nobel Medical College Teaching Hospital. A total of 300 pregnant women was selected by using non- probability consecutive sampling technique. Data was collected by using standard tool, Pregnancy Stress Rating Scale (PSRS) and Brief Cope. Data analysis was done by descriptive and inferential statistics.&#x0D; Results: The study revealed that 40.7% of the respondents experienced a high level of stress and 84.0% of respondents had used adequate coping strategies where “self- distraction” was the most used coping strategy by the respondents with a mean score (2.99±.56). Stress and coping strategies had positive mild correlation (r=0.040).&#x0D; Conclusions: More than one-third of the respondents had experienced a high -level stress and the majority of the respondents had used adaptive coping strategies. The different methods of coping strategies during pregnancy should be expanded as per the best available evidence to lower stress and other adverse outcomes of stress.&#x0D; Keywords: Brief cope, coping strategies, pregnancy stress rating scale, stress

Psychological health of women who have conceived using assisted reproductive technology in Taiwan: findings from a longitudinal study

BackgroundDespite the increasing use of Assisted Reproductive Technology (ART) and the significant physical and emotional commitments that these treatments and procedures involve, only limited evidence exists regarding the psychological health of women who undergo ART. This study investigated the changes over time in the psychological health of women who have conceived using ART during the first, second, and third trimesters of pregnancy and during the postpartum period in Taiwan.MethodsA quantitative longitudinal study was conducted at a fertility centre in Taiwan. 158 pregnant women who had conceived using ART completed a web-based questionnaire that included the following instruments: State Anxiety Inventory, Edinburgh Postnatal Depression Scale, Modified Maternal Foetal Attachment Scale, Pregnancy Stress Rating Scale, Maternity Social Support Scale, Intimate Bond Measure, and Parenting Stress Index. The data were collected the first (9–12 weeks), second (19–22 weeks), third (28–31 weeks) trimesters of pregnancy and at 7–10 weeks postpartum.ResultsLevels of anxiety and depression, which are both key indicators of psychological health, were highest during the first trimester, with scores of 42.30 ± 11.11 and 8.43 ± 4.44, respectively. After the first trimester, anxiety scores decreased and remained stable through the remainder of pregnancy, with scores of 38.03 ± 10.58 in the second and 38.39 ± 10.36 in the third trimester, but increased at two-months postpartum, attaining a score of 41.18 ± 11.68. Further, depression scores showed a similar pattern, declining to a mean of 7.21 ± 4.23 in the second and 6.99 ± 4.11 in the third trimester and then increasing to 8.39 ± 5.25 at two-months postpartum. Pregnancy stress and social support were found to be the most important predictors of change in psychological health during pregnancy and the postpartum period.ConclusionPsychological health was found to be poorest during the first trimester and at two-months postpartum. Moreover, pregnancy stress and social support were identified as key predictors of change in psychological health. The findings indicate a need for increased sensitivity among healthcare professionals to the psychological vulnerability of women who have conceived using ART as well as a need to introduce tailored interventions to provide appropriate psychological support to these women.

The associations between maternal lifestyles and antenatal stress and anxiety in Chinese pregnant women: A cross-sectional study

The study aimed to investigate the associations between maternal lifestyles and antenatal stress and anxiety. 1491 pregnant women were drawn from the Guangxi birth cohort study (GBCS). A base line questionnaire was used to collect demographic information and maternal lifestyles. The Pregnancy Stress Rating Scale (PSRS) and Self-Rating Anxiety Scale (SAS) were used to assess prenatal stress and anxiety, respectively. Regression analyses identified the relationship between maternal lifestyles and prenatal stress and anxiety: (1) Hours of phone use per day was positively correlated to prenatal stress and anxiety and increased with stress and anxiety levels (all P trend < 0.05). In addition, not having baby at home was positively correlated to prenatal stress. (2) Self-reported sleep quality was negative with prenatal stress and anxiety, and decreased with stress and anxiety levels (all P trend < 0.01). Moreover, not frequent cooking was negatively correlated to prenatal stress and having pets was negatively correlated to prenatal anxiety (P < 0.05). However, having pets was not correlated to prenatal stress (P > 0.05). Our results showed that adverse lifestyles increase the risk of antenatal stress and anxiety, a regular routine and a variety of enjoyable activities decreases the risk of prenatal stress and anxiety.

Psychological factors influencing choice of prenatal diagnosis in Chinese multiparous women with advanced maternal age

Objectives: To investigate the psychological predictors in Chinese multiparous pregnant women of advanced maternal age (AMA) for choosing aneuploidy screening or diagnostic testing.Methods: A total of 84 pregnant women of AMA were consecutively enrolled from Renming Hospital, Wuhan University. All participants completed three questionnaires: Zung Self-Rating Anxiety Scale (SAS), Zung Self-Rating Depression Scale (SDS), and Pregnancy Stress Rating Scale (PSRS). Demographic information and the choice of noninvasive prenatal testing (NIPT) versus invasive prenatal diagnosis (PND) were also collected.Results: Thirty-seven chose to have invasive PND, and 47 chose NIPT. Choosing invasive PND, as opposed to NIPT, was associated with lower educational background (χ2 = −2.269, p = .023), higher SAS scores (47.62 ± 7.96 versus 44.21 ± 6.10, p = .029), and higher SDS scores (50.41 ± 9.80 versus 45.96 ± 11.05, p = .058). Logistic regression analysis further showed that the decisive predictors for invasive PND are SAS (OR =1.106, p = .008) scores, scores of factor 3 in PSRS and the stress from changes of shape and motility (OR =0.471, p = .038). Subgroup analysis showed that women with previous negative pregnancy experience had higher scores in factor 2-stress (guarantee of maternal-fetal safety: 1.96 ± 0.63 versus 2.49 ± 0.65, p = .004) and total PSRS scores (1.60 ± 0.4 versus 1.83 ± 0.31, p = .044) than those without. Additionally, unemployment post pregnancy was associated with marginally significant higher PSRS scores (p = .083).Conclusions: The decision for invasive PND might be swayed by anxiety and attenuated by pregnancy stress originating from worry about changes in fetal shape and motility (measured by SAS and factor 3 score of PSRS, respectively).

Predictors of Antenatal Psychosocial Stress in Taiwanese Women.

Antenatal stress has been associated with adverse outcomes in mothers and their children. However, little research has been conducted to identify the factors associated with psychosocial stress in pregnant women. This study explored the predictors of psychosocial stress during pregnancy. A convenience sample of 136 second-trimester and 164 third-trimester pregnant women were recruited from a medical center in southern Taiwan. Data were collected using a demographic form, Pregnancy Stress Rating Scale (PSRS), Edinburgh Prenatal Depression Scale, Pittsburgh Sleep Quality Index, Maternal-Fetal Attachment Scale, and Interpersonal Support Evaluation List. The results of this study found positive correlations between PSRS and both Edinburgh Prenatal Depression Scale (r = .368, p < .01) and Maternal-Fetal Attachment Scale (r = .168, p < .01) and negative correlations between PSRS and both gravidity (r = -.137, p < .05) and Interpersonal Support Evaluation List (r = -.266, p < .01). Higher pregnancy stress was predicted by depression, lower social support, maternal-fetal attachment, and primigravid status, which together explained 20% of the total variance. Depression, social support, maternal-fetal attachment, and gravidity are discrete predictive factors of psychosocial stress in pregnant women. These findings add to existing knowledge of the factors associated with prenatal stress. Future research should include depression in a support model of antenatal stress management.

Relationship between prenatal maternal stress and sleep quality in Chinese pregnant women: the mediation effect of resilience

ObjectiveTo examine the relationship between prenatal maternal stress, resilience, and sleep quality, and to determine whether resilience plays a mediating role in the relationship between prenatal maternal stress and sleep quality among pregnant women. MethodsTwo hundred and thirty-one pregnant women in their second trimester participated in the study. They completed questionnaires, including: the Pittsburgh Sleep Quality Index (PSQI), the Pregnancy Stress Rating Scale (PSRS), and the 10-item Connor-Davidson Resilience Scale (CD-RISC-10). A structural equation model was used to analyze the relationships among prenatal maternal stress, resilience, and sleep quality, with resilience as a mediator. ResultsPrenatal maternal stress was negatively associated with sleep quality in pregnant women (p < 0.01), whereas resilience was positively associated with sleep quality (p < 0.01). Furthermore, resilience mediated the relationship between prenatal maternal stress and sleep quality, and the mediation effect ratio was 22.0% (p < 0.01). ConclusionsThe risk factor for disturbed sleep was pregnancy-specific stress; however, the protective factor for sleep quality was resilience. This finding could provide scientific evidence for the development of intervention strategies with which to improve sleep quality in pregnant women.

Effect of pregnancy-specific stress on spontaneous preterm birth among Chinese people

Background: The current evidence implicates that psychosocial stress, especially pregnancy-specific stress, is associated with the risk of spontaneous preterm birth.The aim of the present study was to determine the effect of pregnancy-specific stress on spontaneous preterm birth among Chinese people. Materials and Methods: A total of 2,189 pregnant women were enrolled and followed up until parturition from February 2011 to January 2012. Maternal pregnancy-specific stress was assessed using the revised Pregnancy Stress Rating Scale (PSRS) at third trimester in pregnancy. Socio-demographic and psychological data were collected through interviews, medical, and obstetrical examination records. Results: High levels of maternal pregnancy-specific stress during the third trimester increased risk of spontaneous preterm birth compared with the low and medium levels (adjusted risk ratios, 2.92; 95% confidence interval, 1.12 - 7.58). The first stressor from the revised PSRS includes a risk factor for the safety of infants. Conclusions: High level of pregnancyspecific stress in third trimester might predict spontaneous preterm birth.