Pregnancy Stress Rating Scale Research Articles

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.

Across-sectional study on anxiety and stress in pregnant women with chronic HBV infection in the People's Republic of China.

PurposeTo investigate the anxiety and pregnancy-associated stress of pregnant women with chronic hepatitis B virus (HBV) infection in the People’s Republic of China and analyze the relationship between anxiety and pregnancy-associated stress in the hope of finding ways to reduce the stress or improve the coping skills for these mothers-to-be during pregnancy.MethodsA cross-sectional study was conducted. One hundred and sixty chronic HBV-infected pregnant women (HBV group) and 160 healthy pregnant women (control group) selected from three Peking University-affiliated hospitals participated in the study, and completed the State-Trait Anxiety Inventory (STAI) and Pregnancy Stress Rating Scale (PSRS) survey.ResultsThe mean scores of STAI and PSRS for the HBV group were higher than for the control group. Factor 2 of PSRS (stress caused by worrying about mother and child’s health and safety) was the highest, and was significantly higher in the HBV group than in the control group. Correlation analysis showed STAI scores were significantly correlated with economic status and diagnosis, as well as the total score, factor 1 (stress about identifying with the role of mother), and factor 2 of PSRS, but not significantly correlated with factor 3 of PSRS (stress caused by the changes of body shape and physical activity).ConclusionPregnant women with chronic HBV infection experienced higher levels of anxiety and stress than healthy pregnant women. Their major stress came from concerns for the health and safety of the mother and the child.

The effects of music listening on psychosocial stress and maternal–fetal attachment during pregnancy

ObjectiveWhile music listening has been studied as an intervention to help reduce anxiety in pregnant women, few studies have explored the effect of music listening on pregnancy-specific stress relief. This study examines the effects of music listening on psychosocial stress and maternal–fetal attachment during pregnancy. DesignA randomized controlled trial was implemented. A valid sample of 296 pregnant women in their second or third trimester was randomly distributed into an experimental group (n=145) and a control group (n=151). InterventionsThe experimental group received routine prenatal care and music listening. The control group received routine prenatal care only. Main outcome measuresData were collected using a demographic form, Pregnancy Stress Rating Scale (PSRS), Perceived Stress Scale (PSS), and Maternal–Fetal Attachment Scale (MFAS). ResultsThe post-test results identified a significantly lower level of psychosocial stress in the experimental group than in the control group, particularly in terms of the stresses related to baby care and changing family relationships and to maternal role identification. However, no statistically significant differences in terms of perceived stress and maternal–fetal attachment were found between the post-test results of the two groups. ConclusionThis study provides evidence in support of using of music in interventions designed to relieve psychosocial stress in prenatal women.IRB approval number: ER98223

Revision and validation of a scale to assess pregnancy stress.

Pregnancy is a potentially stressful event. Prenatal stress alters maternal endocrine and immune systems, has been implicated in the etiology of prenatal complications or postnatal psychiatric disorders, and may adversely affect fetal health. The 30-item Pregnancy Stress Rating Scale (PSRS), initially developed in 1983 by Chen and colleagues, is the only measure to date designed specifically to evaluate prenatal stress. The purpose of this study was to reconsider and revise the 30-item PSRS and validate the new PSRS. A cross-sectional design was used. Adding new items of pregnancy stress generated from clinical experience and expert recommendations resulted in a 40-item revised PSRS that was more reflective of current social conditions. Three hundred pregnant women, recruited from the antenatal clinic of a medical center in southern Taiwan, completed the revised PSRS to assess its internal consistency, test-retest reliability, construct validity, and convergent and discriminate validity. The final 36-item PSRS (PSRS36) was derived by deleting four items with relatively low item-total correlation coefficients or factor loadings. The resultant 36-item scale showed good internal consistency (α = .92) and 2-week test-retest reliability (r = .82). Factor analysis confirmed construct validity and suggested five prenatal stress dimensions, which explained 52.17% of the total variance. Convergent and discriminate validities were indicated by significant correlations among the PSRS36, Perceived Stress Scale, and Interpersonal Support Evaluation List. The PSRS36 is a psychometrically sound and practical tool for nurses and other healthcare providers to assess prenatal stress and to examine intervention protocols in Taiwanese prenatal women. More research is recommended to determine whether the PSRS36 may be used in other racial-ethnic groups.

Stress, sleep quality and unplanned Caesarean section in pregnant women.

This study examines the relationship among prenatal maternal stress, sleep quality and unplanned Caesarean delivery. For this research, we adopted a prospective survey design and a sample of 200 women in the early stages of labour. The findings were as follows: (i) 11.5% of the participants underwent unplanned Caesarean sections; (ii) based on a Pittsburg Sleep Quality Index split point of 5, approximately 90.5% of the participants experienced poor sleep quality; and (iii) the odds ratio for primiparas undergoing an unplanned Caesarean section was 4.183 times that for multiparas (95% confidence interval (CI) = 1.177 to 14.864), indicating a statistically significant difference. The results also showed that stress was a significant factor related to unplanned Caesarean sections; a 1-point increase on the Pregnancy Stress Rating Scale was associated with a 1.033-fold higher probability of undergoing an unplanned Caesarean section (95% CI = 1.002 to 1.065). Furthermore, prenatal stress was a significant variable that can be used to predict unplanned Caesarean deliveries.

Stress and maternal-fetal attachment of pregnant women during their third trimester.

This study was conducted to investigate the maternal-fetal attachment, pregnancy stress and life-event stress of women during their third trimester and to explore the predictors of the maternal-fetal attachment. Purposive sampling was used to recruit 150 subjects from two hospitals in Kaohsiung. Four instruments were used to collect data: (a) the Demographic Data Questionnaire, (b) the Modified Maternal Fetal Attachment Scale, (c) The Pregnancy Stress Rating Scale, and (d) the Assessment Chart for Stressful Events of Adult Life. Factor analysis of the Modified Maternal Fetal Attachment scale defined four factors: (1) interacting with the fetus, (2) giving of self, (3) identifying the fetus, and (4) fantasizing. Results of the stepwise multiple regression indicated that the best subsets to predict the criterion variable of maternal-fetal attachment, including parity, attendance of prenatal class, stress from seeking safe passage for herself and her child through pregnancy, and the life-event stress, accounted for 32% of variance.

Stressors associated with pregnancy as perceived by pregnant women during three trimesters.

A Pregnancy Stress Rating Scale that rated the incidence and severity of stressors associated with pregnancy was administered to 65 pregnant women during their three trimesters. The scores obtained from this scale were analyzed by factor analysis to determine the relationships within categories of stressor, and were analyzed by MANOVA, ANOVA, and trend analysis to determine the variations among nulliparas and multiparas. Factor analysis of the quantitative data defined three categories of stressor experiences, which were labeled Factor I, Factor II and Factor III. It was found that the effects of parity and trimester, on Factor I and Factor II were not statistically significant. The findings also show that "stress from altering body structure and body function" (Factor III) continues to be an important factor throughout pregnancy. It gradually increases and maximizes during the third trimester. A statistically significant linear trend is revealed in three different trimesters. There is no significant difference, however, between nulliparous and multiparous women.