Goletzke J, Kocalevent R-D, Hansen G, Rose M, Becher H, Hecher K, Arck P C, Diemert A
Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg Eppendorf, 20246 Hamburg, Germany.
Department of Medical Psychology, University Medical Center Hamburg Eppendorf, 20246 Hamburg, Germany; Department of Primary Care, University Medical Center Hamburg Eppendorf, 20246 Hamburg, Germany.
J Psychosom Res. 2017 Nov;102:8-14. doi: 10.1016/j.jpsychores.2017.09.002. Epub 2017 Sep 4.
Prenatal distress has been linked to pregnancy complications and poor offspring's health, despite the fact that longitudinal assessments of various stress dimensions are still lacking. Hence, we aimed to assess perceived stress over the course of pregnancy. Moreover, we examined whether social support and coping styles are linked to prenatal stress trajectories.
Data from 543 women participating in the PRINCE (Prenatal Identification of Children Health) study, a prospective population-based cohort study, was used for the present analyses. Once per trimester the women completed questionnaires regarding different psychometric measures, including the Perceived Stress Scale (PSS). Linear mixed regression models were used to examine perceived stress development longitudinally and to relate social support and coping styles to stress trajectories during pregnancy.
A significant decrease of perceived stress was observed over the course of pregnancy. Stratifying the study sample according to parity, women delivering their first child had continuously lower perceived stress scores compared to women having already one or more children, and a significant decrease during pregnancy was exclusively observed in primiparous women. Both, positive coping strategies and higher perceived and received social support were independently associated with lower perceived stress, while evasive coping strategies were associated with higher levels of perceived stress.
Our study reveals stress perception trajectories during pregnancies in primi- and multiparous women. Our findings underscore the need for intervention strategies aiming to improve social support and positive coping strategies especially in multiparous women in order to reduce the risks for adverse pregnancy outcomes.
尽管目前仍缺乏对孕期不同压力维度的纵向评估，但产前压力已被证实与妊娠并发症及后代健康不佳有关。因此，我们旨在评估孕期的感知压力。此外，我们还研究了社会支持和应对方式是否与产前压力轨迹相关。
本分析使用了来自543名参与PRINCE（儿童健康产前识别）研究的女性的数据，这是一项基于人群的前瞻性队列研究。女性在每个孕期各完成一次关于不同心理测量指标的问卷调查，包括感知压力量表（PSS）。采用线性混合回归模型纵向研究感知压力的变化，并分析孕期社会支持和应对方式与压力轨迹之间的关系。
在孕期过程中，感知压力显著降低。根据产次对研究样本进行分层，与已生育一个或多个孩子的女性相比，首次分娩的女性的感知压力得分持续较低，且仅在初产妇中观察到孕期感知压力显著下降。积极的应对策略以及更高的感知到的和获得的社会支持均与较低的感知压力独立相关，而回避应对策略则与较高水平的感知压力相关。
我们的研究揭示了初产妇和经产妇孕期的压力感知轨迹。我们的研究结果强调了需要采取干预策略，旨在改善社会支持和积极应对策略，尤其是针对经产妇，以降低不良妊娠结局的风险。
