Maternal Psychosocial Stress In The First Trimester Of Pregnancy And Premature Birth: A Follow-up Study

Objective To describe the prevalence and associated factors of maternal psychosocial stress in the first trimester of pregnancy,and explore its relationship with premature birth. And provide evidences for mental health and eugenics among pregnant women in the first trimester.Methods Subjects were the pregnant women who had taken the prenatal care in the First People’s Hospital of Hefei during 2010 Dec. to 2012 Jun. All participants were asked to complete a self-administered questionnaires to collect information on sociodemographic characteristics, willingness and readiness of pregnancy, and pregnancy related anxiety, stress and life events stress of the first trimester of pregnancy by the Pregnancy-related Anxiety Questionnaires, Edinburgh postpartum depression scale(EPDS) and Life Events Questionnaire of Pregnancy, respectively. Chi-square test and Multivariate logistic regression analysis were used to explore the prevalence and associated factors of maternal psychosocial stress in the first trimester of pregnancy,and its relationship with premature birth.Results The detection rate of pregnancy-related anxiety, depression and stress of life events were 30.4%, 32.7% and 9.3% respectively. The multivariate logistic regression showed that no ready for saving money of rearing(OR=1.433, 95%CI= 1.076~1.908) and non-first pregnancy(OR=1.179, 95%CI= 1.018~1.364) were the risk factors of pregnancy-related anxiety in the first trimester in pregnancy, the protective factors of that were 25 to 29 years old(OR=0.781, 95%CI= 0.637~0.958), 30 to 50 years old(OR=0.721, 95%CI= 0.542~0.960), monthly family income between 5 000 and 10000 RMB(OR=0.849, 95%CI= 0.724~0.996), non-resisted pregnancy(OR=0.482, 95%CI= 0.399~0.582)and desire pregnancy(OR=0.433, 95%CI= 0.349~0.537); the risk factor of depression in the first trimester in pregnancy were no ready for saving money of rearing(OR=1.542, 95%CI= 1.165~2.040)and reduce the working time and strength in pregnancy(OR=1.190, 95%CI= 1.029~1.376), and the protective factors were monthly family income between 5 000 and 10 000 RMB(OR=0.809, 95%CI= 0.693~0.944) and education for high school or technical secondary school(OR=0.765, 95%CI= 0.601~0.973), junior college( OR=0.719, 95%CI= 0.562~0.920), undergraduate or above(OR=0.711, 95%CI= 0.537~0.941), non-resisted pregnancy(OR=0.807, 95%CI= 0.667~0.975)and desire pregnancy(OR=0.703, 95%CI= 0.566~0.871); no ready for saving money of rearing(OR=1.548, 95%CI= 1.021~2.346) was the risk factor of life events stress in the first trimester in pregnancy, and the protective factors were non-resisted pregnancy(OR=0.533, 95%CI= 0.405~0.701)and desire pregnancy(OR=1.548, 95%CI= 1.021~2.346). Preterm delivery as the dependent variable and the score of pregnancy related anxiety, stress and life events stress as independent variables. Univariate logistic regression analysis showed that pregnancy stress was significantly associated with preterm delivery, but pregnancy related anxiety and life events stress were not significantly associated with it. Based on the univariate analysis, controlling for confounding factors, multivariate logistic regression analysis showed that pregnancy related anxiety, stress and life events stress were all not associated with preterm delivery.Conclusion Pregnant women ages, monthly family income, pregnancy intentions and readiness were associated with maternal psychosocial stress in the first trimester of pregnancy. Even through maternal psychosocial stress was not significantly associated with preterm delivery, but its influence should be widespread interest.