Prenatal Psychosocial Profile Research Articles

Comparison of early risk factors between healthy siblings and subjects with schizophrenia and bipolar disorder.

The following work aims to compare the types and magnitude of risk events in patients with Schizophrenia and Bipolar Disorder and each of those groups with of a group of healthy siblings, exploring differences and similarities of the two psychotic disorders. Retrospective interviews were conducted with 20 families to investigate maternal and obstetric health, social support and the presence of early trauma for the affected family members and healthy siblings. Mothers were interviewed with the Prenatal Psychosocial Profile and each family participant was assessed with the Early Trauma Inventory, Screening Questionnaire of the Genomic Psychiatry Cohort and the Diagnostic Interview for Psychosis and Affective Disorders. Obstetric and gestational history, pregnancy weight changes and early trauma were associated with offspring's mental illness, including statistically significant findings for complications of pregnancy, pregnancy weight changes, general trauma, physical punishment and emotional abuse. These findings highlight the different risk factor exposures that occur within a family, which may increase the risk for severe mental illness.

A Cross-Sectional Study of the Marital Attitudes of Pregnant Women at Risk for Cystic Fibrosis and Psychological Impact of Prenatal Screening.

Cystic fibrosis (CF) is one of the most frequent genetic disorders in those with Northern European ancestry. Prenatal testing for cystic fibrosis may be used to plan and prepare for the birth of a child with the disease or to determine whether to terminate the pregnancy. The accessibility of prenatal detection for women with a high genetic risk of delivering a child with cystic fibrosis is determined by CF carriers and those affected by the disease. Moreover, prenatal testing for CF is mainly dependent on invasive diagnostic tests that can influence the mental health of the pregnant woman, and it is assumed that the birth of a CF child will have a serious influence on the couple’s subsequent family planning and marital behavior. The purpose of this research was to examine the marital attitudes of women at risk for cystic fibrosis and the psychological effect of screening for CF among pregnant women. The study followed a cross-sectional design with five questionnaires comprising Prenatal Attachment Interview (PAI), Maternal Antenatal Attachment Scale (MAAS), Pregnancy-Related Anxiety Questionnaire (PRAQ-R2), the Prenatal Psychosocial Profile (PPP), and the Marital Intimacy Questionnaire (MIQ). A total of 84 pregnant women were included in the “carriers” group for CFTR and 91 in the “non-carrier” group. CFTR-carrier mothers were likely to be more affectionate to the fetus, with better maternal–fetal quality and intensity of attachment. The same group of pregnant women was less scared of giving birth or worried about bearing a physically or mentally handicapped child compared to women who were expecting the prenatal diagnosis test for being at risk of delivering a newborn with malformations. CFTR-carrier pregnant women did not score significantly different results in the Prenatal Psychosocial Profile regarding stress levels, social support, and self-esteem. It was also found that intimacy and consensus problems inside the marriage were significantly more often experienced by CFTR carriers. Based on the current findings, it is likely that CFTR-carrier mothers have a better perception of the possible pregnancy outcomes by knowing their abnormal gene carrier status. Therefore, the psychological impact of invasive diagnostic tests is lower in this category compared with those who are unaware of the possible pregnancy outcomes. However, we promote a future analysis for pregnant women with moderate risk of giving birth to a child with single-gene mutations such as cystic fibrosis or other congenital malformations that undergo noninvasive prenatal diagnosis tests, as they become more accurate and might cause lower pre-diagnosis stress levels.

Relationship of the prenatal psychosocial profile with postpartum maternal duties and newborn care.

This study aimed to determine the relationship of the prenatal psychosocial profile with postpartum maternity duties and newborn care. This descriptive and correlational study was conducted on 154 pregnant women. It was determined that pregnant women had low-stress levels, high social support from their husbands and other people, and moderate self-esteem. Participants relying on power in coping with maternity duties in the postpartum period and satisfaction with maternity and newborn care were found to be high. Adaptation to the postpartum period facilitates the transition to maternity and increases satisfaction with newborn care.

Prenatal Psychosocial Profile: Validity and Reliability Study to Its Use in Turkey

Objective: This study was planned to test the statistical properties of the prenatal psychosocial profile assessment tool in Turkish sample and to examine its validity and reliability on healthy pregnant women.
 Methods: This reliability and validity study was conducted in the gynecology and obstetrics outpatient clinic of a training and research hospital with 440 healthy pregnant women between March and June 2017.
 Results: In the analysis performed for internal consistency in the Prenatal Psychosocial Profile (PPP) reliability study, Cronbach’s alpha reliability coefficient was found to be μ=.75 for the stress subscale, μ = .94 for the social support-partner subscale, μ = .96 for the social support-other people subscale, and μ= .80 for the self-esteem subscale. In the construct validity of the PPP-stress subscale, loads of all items except one item were found to be sufficient, and in the social support-partner, social support-other people, and self-esteem subscales, loads of all items were found to be sufficient.
 Conclusion: The Prenatal Psychosocial Profile-Turkish Version is a valid and reliable assessment tool that can be used to determine the psychosocial profile of women during pregnancy.

Effect of Home Visiting with Pregnant Teens on Maternal Health.

Determine the extent that participation in Resource Mothers Program (RMP) home visiting improves maternal health at 3 months postpartum. A randomized controlled trial using RMPs in two urban and one rural location in a mid-Atlantic state. Community health workers from these RMPs enrolled teens into the study and the research team assigned participants to either the intervention group or telephone support control group using computerized randomization assignments. Data collection from baseline and 3 months postpartum using the Edinburgh Postnatal Depression Scale (EPDS) and the Prenatal Psychosocial Profile (PPP) is reported. The sample included 150 pregnant teens with a mean age of 17 years. Mean self-esteem scores between groups were not significantly different at baseline, but the RMP group self-esteem scores improved significantly at the 3 months postpartum interview (36.40 ± 5.63 for RMP vs. 34.10 ± 4.29 telephone control group, p = 0.049). Neither group was at risk for depression at baseline or 3 months postpartum. Because 60% of the total sample identified as Hispanic, post hoc analysis revealed significantly different baseline stress mean scores between Hispanic and non-Hispanic teens (p = 0.038); however, these differences were no longer significant by 3 months postpartum (p = 0.073). The EPDS scores by ethnicity were not different at baseline (p = 0.875) but were significantly different at 3 months (p = 0.007). The RMP home-visiting intervention can lead to improved self-esteem scores in teens, particularly in Hispanic teens. Improved self-esteem has been shown to lead to better parenting.

Social support, religious commitment, and depressive symptoms in pregnant and postpartum women

Objective: Social support and religious commitment were examined in relation to antenatal and postpartum depressive symptoms in a prospective, longitudinal study to determine whether religious commitment explained variance in depression scores beyond that accounted for by social support. Background: Social support and religiosity are positively related to good mental/physical health, and depression is related to poor health outcomes in pregnancy and postpartum. It was hypothesised that social support and religious commitment would be inversely related to depressive symptoms, and that religious commitment would predict variance in depression scores over and above social support. Methods: In 106 mostly low SES Appalachian pregnant women, social support and religious commitment were measured during the first trimester. First and third trimester (Center for Epidemiological Studies Depression Scale – 10 item version), and 6 weeks and 6 months postpartum (Edinburgh Postnatal Depression Scale) depression symptoms were measured. Hierarchical regression examined relative contributions of social support (Prenatal Psychosocial Profile) and religious commitment (Religious Surrender and Attendance Scale – 3 Item Version) to depressive symptoms at each time point while controlling for education and marital status. Results: Regression results indicated that social support and religious commitment explained 10–18% and 0–3% of the variability in depression scores, respectively. Conclusion: Both social support (all time points) and religious commitment (only at 6 months postpartum) were inversely related to depression. Pregnant women low in social support and postpartum women low in social support or religious commitment may be at increased risk for depression.

Depression, stress and guilt are linked to the risk of suicide associated to ectopic pregnancy

OBJECTIVE: To identify the risk for suicidal behavior in women who had a fetal loss resulting from ectopic pregnancy and verify the association of suicide risk with depression and psychosocial aspects. METHODS: Thirty-one women diagnosed with an ectopic pregnancy were interviewed. Major depression was identified using the Primary Care Evaluation of Mental Disorders questionnaire. The Prenatal Psychosocial Profile questionnaire was used to measure stress, social support and self-esteem. RESULTS: We found that 16% (n = 5) reported suicide risk behavior. The correlation between suicide risk and symptoms of major depression, stress and guilt was statistically significant. CONCLUSIONS: Depression and stress have been linked to the presence of suicide risk, further increasing the vulnerability of women with ectopic prgnancy, which generates intense emotional reactions as guilt.

Prenatal Psychosocial Profile: translation, cross-cultural adaptation and validation to its use in Brazil

Objectivesto translate the Prenatal Psychosocial Profile (PPP) to be used in Brazil; to perform its cross-cultural adaptation; and to evaluate its reliability and validity. Designmethodological study. Settingthe study was conducted in 10 prenatal care clinics at the city of Porto Alegre/Brazil. Participants241 women pregnant women. Methodsthe adaptation process consisted in: translation; first version synthesis; expert committee evaluation; back translation; pre-test of the PPP version in Portuguese (PPP-VP); validation; the data with the participants was collected in 2007, by trained student nurses that approached the women while they were waiting for prenatal consultation. Findingsthe mean scores for all subscales were similar to the ones found by the original authors; internal consistency was verified through Cronbach׳s alpha, with values of 0.71 for the stress subscale; 0.96 for support from the partner; 0.96 for support from others; and 0.79 for self-esteem; validity was supported through factorial analysis; construct and criterion validities were also established. ConclusionPPP-VP should be used as a tool to obtain a psychosocial profile which can lead to nursing interventions that will reduce health risk behaviours during pregnancy.

Measurement of Perceived Stress Among Pregnant Women: A Comparison of Two Different Instruments.

Assess the amount of agreement between the classification of stress from the Perceived Stress Scale (PSS) and the Assessment of Stress portion of the Prenatal Psychosocial Profile (PPP) among pregnant women. A secondary data analysis on a cross-sectional study of 301 pregnant women from the New Orleans and Baton Rouge areas who were exposed to Hurricane Katrina was conducted. Women with complete data (219) were analyzed. Women scoring in the third tertile of each instrument were compared. The kappa statistic was used to assess agreement between instruments. Additional comparisons were made with three instruments that measure other important psychosocial constructs that could be related to stress: the Edinburgh Depression Scale (EDS) and the Assessments of Support (partner and other support) and Self-Esteem from the PPP. No significant difference was found between the two tests. The PSS and the PPP were both statistically significantly correlated to each other (ρ = 0.71, p < 0.01). Thirty-five women were classified discordantly resulting in a Kappa Coefficient of 0.61 (95% CI 0.50-0.72, p < 0.01). No significant differences were found between these two instruments in correlation with the EDS (PPP, r = 0.76; PSS, r = 0.72; p < 0.01 for each), partner support (PPP, r = -0.47; PSS r = -0.46; p < 0.01 for each), other support (PPP, r = -0.31; PSS r = -0.32; p < 0.01 for each) and self-esteem (PPP, r = -0.41; PSS, r = -0.52; p < 0.01 for each), respectively. Given the similarities between the PSS and PPP, researchers are encouraged to choose and administer one instrument to participants, or to use the instruments in combination as an external reliability check.

Anxiety and Psychological Stress Before Prenatal Screening in First-Time Mothers Who Conceived Through IVF/ICSI or Spontaneously

Mothers’ general anxiety, anxiety about the well-being of the child and psychological stress before prenatal testing was studied by comparing women who conceived through in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) with women who conceived naturally. Before the first trimester screening test for Down’s syndrome, a group of 51 women who conceived through IVF/ICSI and a group of 54 women who conceived spontaneously completed the State Scale of the State-Trait Anxiety Inventory (S-Anxiety; Spielberger, 1983), the Fear of Bearing a Physically or Mentally Handicapped Child Subscale of the Pregnancy-related Anxiety Questionnaire (PRAQ-R; Huizink et al., 2004), the Psychological Stress Measure (PSM; Lemyre & Tessier, 1988), and the Prenatal Psychosocial Profile (PPP; Curry, Campbell, & Christian, 1994). Women who conceived through IVF/ICSI had more elevated levels of general anxiety and psychological stress than the women who conceived naturally; however, no difference was observed between the two groups for anxiety specifically related to the health of the child. These results underline the need to monitor women’s emotional state after conception via IVF/ICSI—when counseling usually ends—and around the time of the first trimester screening. Counseling might thus be extended.

Twin Pregnancies: Evaluation of Major Depression, Stress, and Social Support

Twin pregnancies are at increased physiological and psychosocial risks. To investigate the prevalence of major depression in twin pregnancies and correlate with stress and social support. The study included 51 pregnant women under specialized prenatal care who were evaluated by a Portuguese version of the semi-structured questionnaire Primary Care Evaluation of Mental Disorders (PRIME-MD) for Major Depression, and the Prenatal Psychosocial Profile (PPP) for evaluation of stress and social support. Major depression was found in 33.3% of pregnant women, and prevailing symptoms were fatigue or loss of energy (100%), insomnia or hypersomnia (82.4%), changes in appetite (82.4%), decreased interest in daily activities (82.4%), and psychomotor agitation or retardation (82.4%). Among pregnant women who were diagnosed depressive, 76.5% also had a high level of stress and 47.1% complained about lack of social support. Statistical significance was found when correlating depression with perception of negative aspects of having twins and belief in significant body changes during pregnancy (p = .005 and .03, respectively). Marital status, occupation, and pregnancy planning were not significantly associated with the diagnosis of depression. Major depression occurs in one-third of pregnant women expecting twins and is associated with higher levels of stress and lack of social support. A multidisciplinary approach in these cases is fundamental to minimize further risks and complications.

Surrender to God and stress: A possible link between religiosity and health.

An abundance of evidence supports that stress predicts poor health, and religiosity, broadly defined, typically predicts good health. It is possible that one mechanism by which religiosity positively impacts health is through reduction in or prevention of the stress response, and that Surrender (Surrender to God) is a measure that captures aspects of religiosity that would predict lowered stress levels. In the present investigation, two samples were studied in order to investigate the relationship between one characterization of religiosity (Surrender) and stress. Participants in Study 1 were 460 (306 female) Southern Appalachian undergraduate university students who completed the Surrender Scale (Wong-McDonald & Gorsuch, 2000) and the State–Trait Anxiety Inventory (STAI, Spielberger, 1983) online during spring 2009. Study 2 utilized a high-risk (low income and/or high pregnancy risk) sample of 230 pregnant women involved in a longitudinal study who completed the Surrender Scale and the Prenatal Psychosocial Profile (PPP, Curry, Campbell, & Christian, 1994), which contains an 11-item stress measure, during their first research contact early in pregnancy. Hierarchical regression analysis revealed that Surrender was consistently inversely related to stress on both the STAI and the PPP. These findings contribute to the current understanding of the religiosity‐health association in two ways. First, they offer support for Surrender and its associated lower stress levels to be explored as a mechanism by which religiosity influences health. Second, findings support the exploration of the potential for stress reduction through increasing Surrender in reportedly religious individuals.

Factors associated with Maternal-fetal Attachment of Expectant Mothers Whose Fetus Has a Prenatal Diagnosis of Congenital Heart Disease

Purpose: The main purposes of this study were to assess maternal-fetal attachment (MFA) of the expectant mothers of a fetus with a prenatal diagnosis of congenital heart disease (CHD) and to identify factors associated with MFA. Methods: The methodology was a cross sectional survey study using a self-administered questionnaire. Thirty pregnant women carrying a fetus with a prenatal diagnosis of CHD and 30 pregnant women with a normal fetus were enrolled in this study. The MFA Scale and PPS (The Prenatal Psychosocial Profile) were used to collect data. Data were analyzed using SPSS 20.0 Window version. Descriptive statistics, χ²-test and t-test were used to compare the two groups. The factors associated with MFA were identified by multiple regression analysis. Results: There was no significant difference between the two groups in MFA and social support from spouse was the only variable showing a significant difference. The model from the multiple regression analysis explained 33.8% of MFA for both groups. Conclusion: MFA of expectant mothers with a prenatal diagnosis of CHD and of mothers with a normal fetus were not significantly different. It is important that health care providers encourage expectant fathers to support the expectant mothers to increase MFA.

Unique perspectives of women and their partners using the Prenatal Psychosocial Profile Scale

This paper is a report of a study to examine the underlying factors of the Prenatal Psychosocial Profile as a composite measure of stress, support from partner, support from others and self-esteem; and compares factor structures between pregnant women and men. In order to promote positive pregnancy outcomes, addressing unique differences in psychosocial factors between women and men is important. There is very little information or data directly collected from both groups. As part of a larger smoking cessation study during pregnancy, a sample of 66 low-income couples (n =132) living in rural Missouri--the Midwestern region of the United States of America--was selected between 2006 and 2008. Principal component analysis was used to evaluate the factor structure of the composite measure. Similarities and unique differences in the Prenatal Psychosocial Profile subscales between the two groups were found. For the stress subscale, 'problems related to family', 'the current pregnancy' and 'feeling generally overloaded' loaded as financial stressors for men but as emotional stressors for women. For the partner support subscale, women perceived they were receiving more tangible support from their partners whereas men perceived receiving more emotional support. The support from others subscale was similar for both partners. The self-worth factor explained more of the variance in self-esteem among pregnant women, while the self-criticism factor explained more of the variance among men. Assessment of psychosocial well-being in both women and men during pregnancy, especially careful assessment of stressors of pregnancy should be part of nursing practice.

Psychosocial Stress during Pregnancy

Objective We sought to identify factors associated with high antenatal psychosocial stress and describe the course of psychosocial stress during pregnancy. Study Design We performed a cross-sectional analysis of data from an ongoing registry. Study participants were 1522 women receiving prenatal care at a university obstetric clinic from January 2004 through March 2008. Multiple logistic regression identified factors associated with high stress as measured by the Prenatal Psychosocial Profile stress scale. Results The majority of participants reported antenatal psychosocial stress (78% low-moderate, 6% high). Depression (odds ratios [OR], 9.6; 95% confidence interval [CI], 5.5–17.0), panic disorder (OR, 6.8; 95% CI, 2.9–16.2), drug use (OR, 3.8; 95% CI, 1.2–12.5), domestic violence (OR, 3.3; 95% CI, 1.4–8.3), and having ≥2 medical comorbidities (OR, 3.1; 95% CI, 1.8–5.5) were significantly associated with high psychosocial stress. For women who screened twice during pregnancy, mean stress scores declined during pregnancy (14.8 ± 3.9 vs 14.2 ± 3.8; P Conclusion Antenatal psychosocial stress is common, and high levels are associated with maternal factors known to contribute to poor pregnancy outcomes.

Psychosocial stress during pregnancy

We sought to identify factors associated with high antenatal psychosocial stress and describe the course of psychosocial stress during pregnancy. We performed a cross-sectional analysis of data from an ongoing registry. Study participants were 1522 women receiving prenatal care at a university obstetric clinic from January 2004 through March 2008. Multiple logistic regression identified factors associated with high stress as measured by the Prenatal Psychosocial Profile stress scale. The majority of participants reported antenatal psychosocial stress (78% low-moderate, 6% high). Depression (odds ratios [OR], 9.6; 95% confidence interval [CI], 5.5-17.0), panic disorder (OR, 6.8; 95% CI, 2.9-16.2), drug use (OR, 3.8; 95% CI, 1.2-12.5), domestic violence (OR, 3.3; 95% CI, 1.4-8.3), and having > or =2 medical comorbidities (OR, 3.1; 95% CI, 1.8-5.5) were significantly associated with high psychosocial stress. For women who screened twice during pregnancy, mean stress scores declined during pregnancy (14.8 +/- 3.9 vs 14.2 +/- 3.8; P < .001). Antenatal psychosocial stress is common, and high levels are associated with maternal factors known to contribute to poor pregnancy outcomes.

Nurse Case Management for Pregnant Women Experiencing or at Risk for Abuse

To determine whether individualized nursing case management can decrease stress among pregnant women at risk for or in abusive relationships. A multisite randomized controlled trial. Two prenatal clinics in the Pacific Northwest and rural Midwest. 1,000 women who spoke English and were 13 to 23 weeks pregnant at time of recruitment. All intervention group women (N = 499) were offered an abuse video and had access to a nurse case manager 24/7. Additionally, participants at risk for or in abusive relationships received individualized nursing care management throughout the pregnancy. The most frequent nursing care management activities were providing support (38%) and assessing needs (32%). The nursing care management group received an average of 22 contacts, most (80%) by telephone and had a significant reduction in stress scores as measured by the Prenatal Psychosocial Profile. Compared to the control group, the differences were in the predicted direction, but not statistically different. A major finding was the choice by abused women to focus on basic needs and their pregnancies rather than the abuse, although all received safety planning. Pregnant women at risk for or in abusive relationships experience very stressful and complex lives. Nurses need to focus on the needs they identify, which may not be the abusive relationship.

Relationships Between Physical Abuse During Pregnancy and Risk Factors for Preterm Birth Among Women in Manitoba

To describe the prevalence and correlates of physical abuse during the year of pregnancy and to explore the association between physical abuse and other risk factors for preterm birth. Secondary analysis of data from a case-control study of risk factors for preterm birth. Two tertiary care hospitals in the Canadian province of Manitoba. Six hundred eighty postpartum women who delivered a live singleton newborn after spontaneous onset of labor. Instruments included the Abuse Assessment Screen, Prenatal Psychosocial Profile, Perceived Stress Scale, and a questionnaire to collect data on demographic characteristics, complications during pregnancy, and lifestyle behaviors. Sixty-four women (9.4%) reported being physically abused during the year of pregnancy. Abused women were significantly more likely to be younger, single, of lower income, and less educated than nonabused women. Significant correlates of abuse, after adjusting for other factors in a logistic regression, included the following: illicit drug use, low support from partner, moving two or more times in the past year, high life event stress, bladder infection during pregnancy, Aboriginal race/ethnicity, and single marital status. This study suggests that physical abuse during pregnancy is associated with other risk factors for preterm birth, particularly stress and behavioral risk factors such as substance abuse.

Risks and Protective Factors Associated With Symptoms of Depression in Low-Income African American and Caucasian Women During Pregnancy

This article describes the risks and protective factors for symptoms of depression in pregnancy among low-income African American and Caucasian women. Data were collected from 130 women who were between 16 and 28 weeks' gestation and enrolled in an urban prenatal clinic. The questionnaires used in the face-to-face interviews consisted of sociodemographic items, the Beck Depression Inventory (BDI-II), the Prenatal Psychosocial Profile (PPP), 3 items from the Jarel Spiritual Well-Being Scale, the Spiritual Perspective Scale, and 4 items on health risk behaviors. Twenty-seven percent of the women reported depressive symptoms at levels indicating risk for clinical depression. However, there were no significant differences between African American and Caucasian women. Sociodemographic factors accounted for 13% of the variance (P < .01) in BDI-II scores. Psychosocial and behavioral risk factors accounted for an additional 19% of the BDI-II variance (P < .001), and psychosocial and spiritual resources accounted for 7% of the variance (P < .001), resulting in these variables accounting for 54% of the total variance in BDI-II scores. Higher levels of stress, lower levels of self-esteem and social support, and higher religiosity had a significant relationship with more symptoms of depression. This supports the need to routinely screen for and to assess factors associated with depressive symptoms in pregnant low-income women.

Effects of Spirituality and Psychosocial Well-Being on Health Risk Behaviors in Appalachian Pregnant Women

AbstractObjective: To determine the relationships of spirituality and psychosocial well-being to health risk behaviors in pregnant Appalachian women.Method: Descriptive study of 120 women between 16 and 28 weeks of pregnancy. The instruments used were the Spiritual Perspective Scale and religiosity items from the Jarel Well-Being Scale. Psychosocial well-being was measured by the Prenatal Psychosocial Profile. Four items measured health risk behaviors.Results: Higher levels of spirituality (spiritual perspective and religiosity) were significantly correlated with greater satisfaction with social support, higher levels of self-esteem, and decreased levels of smoking. Sociodemographic, psychosocial, and spiritual variables explained 25% of the variance in frequency of smoking, and in the logistic regression analysis, psychosocial stress was the only variable that significantly predicted substance use.Conclusion: Higher levels of spirituality and lower levels of stress are associated with decreased health risk behaviors among pregnant women from Appalachia. Increasing spiritual resources and decreasing stress during pregnancy offer the potential to improve health promotion efforts in pregnancy with women from Appalachia.