Assessment of significant psychological distress at the end of pregnancy and associated factors
The aim of this study is to study the prevalence of mental distress at the end of pregnancy and after birth and the impact of selected socio-demographic and obstetric factors. This is a cross-sectional study. The sample is consisted of 351 puerperal women at the age of 18 and over. Sociodemographic, obstetric variables were collected to detect significant psychological distress; the instrument used was General Health Questionnaire (GHQ-28). Logistic multivariable regressions were used to investigate associations. The prevalence of significant mental distress amounted to 81.2%, mostly related to social relationship and anxiety. The women who affirmed having more stress during pregnancy had too significantly increased emotional distress before the birth as well as during early puerperium, increasing somatic symptoms (p < 0.001; OR 2.685; CI 95% 1.583–4.553), anxiety (p < 0.001; OR 4.676; CI 95% 2.846–7.684), and depressive symptoms (p < 0.01). Somatic symptoms (p < 0.05; OR 2.466; CI 95% 1.100–5.528) and social dysfunction (p < 0.001; OR 1.672; CI 95% 0.711–3.932) occur most frequently in women who already had children. Regarding socio-demographic data, being an immigrant is the only protective factor reducing the social dysfunction in the last weeks of pregnancy (p < 0.01; OR 0.478; CI 95% 0.274–0.832). Psychological distress at the end of a full-term pregnancy and in the postpartum period occurs frequently and was associated mainly with stress experienced during pregnancy and parity. It is advisable to perform proper assessment of stress and significant psychological distress at the early stage of pregnancy and repeatedly later on until delivery. Information and support from professionals can help to decrease and prevent their negative impact on maternal and fetal health, as observed in the current evidence.
KeywordsHuman development Pregnancy Psychological adaptation Psychological stress Puerperium Women
Compliance with ethical standards
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
- Allison S, Stafford J, Anumba D (2011) The effect of stress and anxiety associated with maternal prenatal diagnosis on feto-maternal attachment. BMC Womens Health 11:33. https://doi.org/10.1186/1472-6874-11-33; 10.1186/1472-6874-11-33 CrossRefPubMedPubMedCentralGoogle Scholar
- Balmón Cruz C, Dorado Primo J (2005) The detection and prevalence of psychopathological morbidity: an epidemiologic study in primary care. An Psiquiat 21:82–87Google Scholar
- Beltrán Jiménez B, Ortiz Acosta R (2011) Depressive symptoms, perceived emotional intelligence and ways of coping among pregnant women. Anxiety Stress 17:255–264Google Scholar
- Castellanos-Cabañas G, Gascón-Buendía A, Lapeña-Moñux Y, López-De Castro F, Pozo-Mula S, Rodríguez Rojas M (2011) Anxiety and depression in pregnancy. Rev Presencia 7Google Scholar
- Marc I, Toureche N, Ernst E, Hordnett E, Blanchet C, Dodin S, Njoya M (2011) Mind-body interventions during pregnancy for preventing or treating women’s anxiety (review). Cochrane Database Syst Rev 7Google Scholar
- Prady SL, Pickett KE, Petherick ES, Gilbody S, Croudace T, Mason D, Sheldon TA, Wright J (2016) Evaluation of ethnic disparities in detection of depression and anxiety in primary care during the maternal period: combined analysis of routine and cohort data. Br J Psychiatry 208:453–461CrossRefPubMedPubMedCentralGoogle Scholar
- Ryff C, Singer B (2003) The role of emotion on pathways to positive health. In: Davidson R, Scherer K, Goldsmith H (eds) Handbook of affective sciences. Oxford University Press, New York, pp 1083–1104Google Scholar
- Sánchez Montoya J, Palacios Alzaga G (2007) Posttraumatic stress disorder on chilbrirth: pregnancy, birth and postpartum. Matronas Prof 1:12–19Google Scholar
- Whisman MA, Davila J, Goodman SH (2011) Relationship adjustment, depression, and anxiety during pregnancy and the postpartum period. J Fam Psychol 25:375–383. https://doi.org/10.1037/a0023790; 10.1037/a0023790 CrossRefPubMedGoogle Scholar