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Factors influencing pregnancy stress in pregnant women in Korea: a cross-sectional study

임부의 임신스트레스에 영향을 미치는 요인에 관한 단면연구

  • Kang, Sook Jung (College of Nursing, Ewha Womans University) ;
  • Yang, Min Ji (Division of Nursing Science, Graduate School, Ewha Womans University)
  • 강숙정 (이화여자대학교 간호대학) ;
  • 양민지 (이화여자대학교 일반대학원 간호과학과)
  • Received : 2021.10.12
  • Accepted : 2022.02.03
  • Published : 2022.03.31

Abstract

Purpose: The purpose of this study was to investigate the association between maternal knowledge and social support on pregnancy stress among pregnant women in Korea. Methods: The participants in this study were 148 pregnant women in Korea, recruited from online communities on pregnancy and/or childbirth, from June 2019 to April 2020. The collected data were analyzed using the independent t-test, one-way analysis of variance, Pearson correlation coefficient, and multiple regression. Results: Participants were at average 18.25±8.28 weeks gestation, 56% were in the second trimester, 31% had one or more health issues in the current pregnancy (e.g., hyperemesis gravidarum), and 76% were first-time mothers. Participants had moderate levels of pregnancy stress (mean, 23.09±7.11 points out of 48) and maternal knowledge (mean, 14.42±4.67 points out of 21), whereas social support was somewhat high (mean 45.88±7.81 points out of 60). Pregnancy stress was weakly negatively correlated with social support (r=-.37, p<.001). Main source of pregnancy information (β=-.21, p=.011), marital satisfaction (β=-.18, p=.036), and social support (β=-.19, p=.038) were identified as significant factors affecting pregnancy stress, and these variables had an explanatory power of 22.7% for pregnancy stress. Conclusion: Based on these findings, nurses should assess pregnancy-related stress during pregnancy and consider main source of pregnancy information and marital satisfaction when providing education or counseling. Moreover, strategies to reduce pregnancy stress through social support are needed to improve the quality of life for pregnant women.

Keywords

References

  1. Cutler A, McNamara B, Qasba N, Kennedy HP, Lundsberg L, Gariepy A. "I just don't know": an exploration of women's ambivalence about a new pregnancy. Women's Health Issues. 2018;28(1):75-81. https://doi.org/10.1016/j.whi.2017.09.009
  2. Staneva AA, Bogossian F, Wittkowski A. The experience of psychological distress, depression, and anxiety during pregnancy: a meta-synthesis of qualitative research. Midwifery. 2015;31(6):563-573. https://doi.org/10.1016/j.midw.2015.03.015
  3. Statistics Korea. Population trend survey for Korea [Internet]. Seoul: Author; 2020 [cited 2021 Dec 9]. Available from: http://kosis.kr/statHtml/statHtml.do?orgId=101&tblId=DT_1B8000H&checkFlag=N
  4. Chung MR, Kim HM, Kang SK. Assessment on the needs of pregnant women regarding pregnancy, childbirth, and parenting-related support policies. Korean J Early Childhood Educ. 2017;37(2):127-148. https://doi.org/10.18023/kjece.2017.37.2.006
  5. Alderdice F, Lynn F. Factor structure of the prenatal distress questionnaire. Midwifery. 2011;27(4):553-559. https://doi.org/10.1016/j.midw.2010.05.003
  6. Obrochta CA, Chambers C, Bandoli G. Psychological distress in pregnancy and postpartum. Women Birth. 2020;33(6):583-591. https://doi.org/10.1016/j.wombi.2020.01.009
  7. Woods SM, Melville JL, Guo Y, Fan MY, Gavin A. Psychosocial stress during pregnancy. Am J Obstet Gynecol. 2010;202(1):61.e1-61.e617. https://doi.org/10.1016/j.ajog.2009.07.041
  8. Yuksel F, Akin S, Durna Z. Prenatal distress in Turkish pregnant women and factors associated with maternal prenatal distress. J Clin Nurs. 2014;23(1-2):54-64. https://doi.org/10.1111/j.1365-2702.2012.04283.x
  9. Christian LM. Physiological reactivity to psychological stress in human pregnancy: current knowledge and future directions. Prog Neurobiol. 2012;99(2):106-116. https://doi.org/10.1016/j.pneurobio.2012.07.003
  10. Lima SAM, El Dib RP, Rodrigues MR, et al. Is the risk of low birth weight or preterm labor greater when maternal stress is experienced during pregnancy? A systematic review and meta-analysis of cohort studies. PLoS One. 2018;13(7):e0200594. https://doi.org/10.1371/journal.pone.0200594
  11. Kwon MK, Bang KS. Relationship of prenatal stress and depression to maternal-fetal attachment and fetal growth. J Korean Acad Nurs. 2011;41(2):276-283. https://doi.org/10.4040/jkan.2011.41.2.276
  12. Fatima M, Srivastav S, Mondal AC. Prenatal stress and depression associated neuronal development in neonates. Int J Dev Neurosci. 2017;60:1-7. https://doi.org/10.1016/j.ijdevneu.2017.04.001
  13. Hong HJ, Mun HJ. The influences of stress and social support during pregnancy on maternal attachment in infancy: An examination of postpartum depression and its mediating effects. Korean J Human Develop. 2011;18(4):125-145.
  14. Fontein-Kuipers Y, Ausems M, Bude L, Van Limbeek E, De Vries R, Nieuwenhuijze M. Factors influencing maternal distress among Dutch women with a healthy pregnancy. Women Birth. 2015;28(3):e36-e43. https://doi.org/10.1016/j.wombi.2015.02.002
  15. Engidaw NA, Mekonnen AG, Amogne FK. Perceived stress and its associated factors among pregnant women in Bale zone Hospitals, Southeast Ethiopia: a cross-sectional study. BMC Res Notes. 2019;12(1):356. https://doi.org/10.1186/s13104-019-4383-0
  16. Hong K, Hwang H, Han H, et al. Perspectives on antenatal education associated with pregnancy outcomes: systematic review and meta-analysis. Women Birth. 2021;34(3):219-230. https://doi.org/10.1016/j.wombi.2020.04.002
  17. Sayakhot P, Carolan-Olah M. Internet use by pregnant women seeking pregnancy-related information: a systematic review. BMC Pregnancy Childbirth. 2016;16:65. https://doi.org/10.1186/s12884-016-0856-5
  18. Racine N, Plamondon A, Hentges R, Tough S, Madigan S. Dynamic and bidirectional associations between maternal stress, anxiety, and social support: the critical role of partner and family support. J Affect Disord. 2019;252:19-24. https://doi.org/10.1016/j.jad.2019.03.083
  19. Jonsdottir SS, Thome M, Steingrimsdottir T, et al. Partner relationship, social support and perinatal distress among pregnant Icelandic women. Women Birth. 2017;30(1):e46-e55. https://doi.org/10.1016/j.wombi.2016.08.005
  20. Staneva A, Bogossian F, Pritchard M, Wittkowski A. The effects of maternal depression, anxiety, and perceived stress during pregnancy on preterm birth: a systematic review. Women Birth. 2015;28(3):179-193. https://doi.org/10.1016/j.wombi.2015.02.003
  21. Barber CC, Steadman J. Distress levels in pregnant and matched non-pregnant women. Aust N Z J Obstet Gynaecol. 2018;58(1):128-131. https://doi.org/10.1111/ajo.12712
  22. Vieten C, Laraia BA, Kristeller J, et al. The mindful moms training: development of a mindfulness-based intervention to reduce stress and overeating during pregnancy. BMC Pregnancy Childbirth. 2018;18(1):201. https://doi.org/10.1186/s12884-018-1757-6
  23. Solivan AE, Xiong X, Harville EW, Buekens P. Measurement of perceived stress among pregnant women: a comparison of two different instruments. Matern Child Health J. 2015;19(9):1910-1915. https://doi.org/10.1007/s10995-015-1710-5
  24. Oh JS, Wright G, Coulam CB. Gestational sac diameter in very early pregnancy as a predictor of fetal outcome. Ultrasound Obstet Gynecol. 2002;20(3):267-269. https://doi.org/10.1046/j.1469-0705.2002.00774.x
  25. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988.
  26. Hwang RH. Effects of state-anxiety and dyadic adjustment on pregnant women's pregnancy stress. J Digit Converg. 2019;17(5):225-233. https://doi.org/10.14400/JDC.2019.17.5.225
  27. Pop VJ, Pommer AM, Pop-Purceleanu M, Wijnen HA, Bergink V, Pouwer F. Development of the Tilburg Pregnancy Distress Scale: the TPDS. BMC Pregnancy Childbirth. 2011;11:80. https://doi.org/10.1186/1471-2393-11-80
  28. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000;25(24):3186-3191. https://doi.org/10.1097/00007632-200012150-00014
  29. Kim HW. Model construction of maternal identity in primigravida. J Korean Acad Nurs. 1998;28(2):510-518. https://doi.org/10.4040/jkan.1998.28.2.510
  30. Zimet GD, Dahlem NW, Zimet SG, Farley GK. The multidimensional scale of perceived social support. J Pers Assess. 1988;52(1):30-41. https://doi.org/10.1207/s15327752jpa5201_2
  31. Capik A, Pasinlioglu T. Validity and reliability study of the Tilburg Pregnancy Distress Scale into Turkish. J Psychiatr Ment Health Nurs. 2015;22(4):260-269. https://doi.org/10.1111/jpm.12211
  32. Hicyilmaz BD. Characteristics associated with prenatal distress in Turkish women: a cross-sectional study. J Midwifery Reprod Health. 2021;9(1):2555-2564. https://doi.org/10.22038/JMRH.2020.50064.1622
  33. Kuipers J, Henrichs J, Evans K. A comparison of the Fear of Childbirth Scale with the Tilburg Pregnancy Distress Scale to identify childbirth-related fear in a sample of Dutch pregnant women: a diagnostic accuracy comparative cross-sectional study. Int J Nurs Stud. 2020;109:103615. https://doi.org/10.1016/j.ijnurstu.2020.103615
  34. Boekhorst MG, Beerthuizen A, Van Son M, Bergink V, Pop VJ. Psychometric aspects of the Tilburg Pregnancy Distress Scale: data from the HAPPY study. Arch Womens Ment Health. 2020;23(2):215-219. https://doi.org/10.1007/s00737-019-00974-4
  35. Cho HW, Woo JY. The relational structure modeling between variables related with postpartum depression. Korean J Couns Psychother. 2013;25(3):549-573.
  36. Kim YK, Lim KH. Risk factors for premature birth among premature obstetric labor women: a prospective cohort study. Korean J Women Health Nurs. 2018;24(3):233-242. https://doi.org/10.4069/kjwhn.2018.24.3.233
  37. Zamani P, Ziaie T, Lakeh NM, Leili EK. The correlation between perceived social support and childbirth experience in pregnant women. Midwifery. 2019;75:146-151. https://doi.org/10.1016/j.midw.2019.05.002