Emotional distress during pregnancy; a time of major transition; was documenting in a substantial number of pregnant women. Parallel literature on the influence of stress; defined as “a negative emotional experience accompanied by biochemical, physiological and behavioral changes”; on the perinatal and long-term maternal and infantile health has quickly grown.
Depressive symptoms may be related to feelings of stress; stress is much more common than depressive symptoms, with 75% of pregnant women self-reporting to feel psychosocially stressed. Both depressive symptoms and stress to be bidirectional; although most studies explicitly examined the risk of depressive symptoms and stress on health-impairing behavior. Proximal risk factors may be defined as women’s characteristics and behavior that are variable and modifiable.
The aim of this study was to provide prevalence data on depressive symptoms; and stress as well as a range of proximal risk factors; for mental health problems in pregnant women; and to comprehensively elucidate the association between proximal risk factors and mental health problems during pregnancy in a cross-sectional and longitudinal nature.
A prospective, longitudinal population
Informed writing consent obtain from all pregnant women. Eligible for the current study were N = 463 pregnant women; with valid data on the dependent variables from the 2nd-trimester assessment of whom n = 349 (75.4%); were reassess at the 3rd-trimester visit. Women had a mean age of 29.8 ± 4.2 years and a mean pregravid body mass index of 23.5 ± 4.3 kg/m2.
In previous research in an US-American sample of 745 pregnant women. The 10-item stress module refers to the frequency of being bother by different problems during the last four weeks. The items of each scale were sum to build separate total scores. Scores of ≥10 were use to detect pregnant women with symptoms of a major depressive disorder; or moderate to high psychosocial stress scores respectively.
Prevalence of proximal risk factors
Pregnant women who were reassessed at the 3rd-trimester visit (n = 349) are compared with those who were assessed at the 2nd-trimester visit only (n = 114). They differed only in Gestational Weight Gain with women who are not reassessed having a lower GWG (p = .023). Concerning GWG, 22.3% (n = 71) adequately gained weight; 44.5% (n = 142) gained too much weight, and 33.2% (n = 106) gained too little weight. Furthermore, 40.6% (n = 106) reported being physically active less than once a week.
Sleep problems are the risk factor mostly reported (67.1%, n = 196). While the mean stress scores were significantly different between the 2nd and 3rd-trimester assessment (p < .001); women’s depression scores were not (p = .563). During the 2nd and 3rd trimester 11.9% (n = 55) and 7.2% (n = 30) exceeded the cut-off for a major depressive disorder, respectively. However; other proximal risk factors were not significantly associating with mental health problems in the cross-sectional and longitudinal analyses.
The fact that physical activity did not emerge as a significant predictor in the current study might be related to the one-item self-report assessment of physical activity; because it is subject to item interpretation, socially desirable response behavior, and recall bias. As substance use in pregnancy is a stigmatized behavior, the low prevalence may to some extent mirror socially desirable response behavior.
The results showed that sleep problems, and particularly pregnancy intention were related to maternal mental health problems during pregnancy. Future research should focus on designing longitudinal studies using standardized measures; particularly diagnostic interviews in order to analyze patterns of risk factors including depressive symptoms and stress.