Study Of The Effect Of Negative Emotions On Pregnancy Outcome Based On The Latent Class Growth Model

Objective: Pregnancy is an important stage in a woman’s life,and a successful delivery with a good pregnancy outcome is the expectation of every pregnant woman.Negative emotions such as stress,anxiety and depression are often present during this period and can have a negative impact on pregnancy outcomes.Attention to the impact of negative psychological conditions in women on birth outcomes remains an important topic.This study,based on a longitudinal observational follow-up study conducted in Chongqing,aims to collect women’s deliveries,explore the impact of different psychological trends during pregnancy on women’s birth outcomes,and provide theoretical support for appropriate interventions to reduce the incidence of adverse pregnancy outcomes.Methods: The data for this study were obtained from the National Natural Science Foundation of China project.The study was conducted in Chongqing,China,and the study population was pregnant women who underwent their first obstetric examination at four county hospitals and voluntarily participated in the study.A structured questionnaire was used to conduct the survey and follow-up at early,mid and late pregnancy,respectively.The information collected included demographic characteristics,prenatal examination data,and personal behavioral characteristics.Stress,anxiety,and depression were assessed using the Pregnancy Stress Scale(PPS),the Hamilton Anxiety Inventory(HAMA),and the Self-Rating Depression Scale(SDS)at each of the three periods.Delivery information was collected at the end of delivery.The latent class growth model was used to describe and group the psychological development trends of the study subjects,and generalized estimating equations were used to evaluate the levels of stress,anxiety,and depression in different periods and in different groups.A logistic regression model was used to explore the factors influencing the occurrence of adverse pregnancy outcomes,and to explore whether different psychological trends during pregnancy would have an impact on pregnancy outcomes.Results:(1)778 women were enrolled in this study and 267 women had adverse pregnancy outcomes,with an incidence of 34.32%.The 3most prevalent adverse pregnancy outcomes were fetal distress(32.21%),premature rupture of membranes(25.09%),and amniotic fluid abnormalities(14.23%).(2)The latent class growth model was used to finally divide the population into 2 groups according to the trend of stress during pregnancy,namely the "mild stress group" and the "moderate stress group".The trend of anxiety during pregnancy was divided into two groups,namely "no anxiety group" and "mild anxiety group".The trend of depression with pregnancy was divided into 4 groups: "no depression-rising group","no depression-stable group","no depression-falling group" and "depression group".The mean post-test probability of each group was greater than 0.7,and the generalized estimating equation showed that there were statistically significant differences in the levels of scores of different trend trajectory groups of stress,anxiety and depression.(3)The incidence of stress was 92.93%,90.75%,and 88.69%in early,mid,and late pregnancy,respectively.The incidence of anxiety was 13.62%,11.05%,and 10.41%,respectively.The incidence of depression was 4.76%,3.98%,and 2.83%,respectively.The levels of stress,anxiety,and depression tended to decrease with the progress of pregnancy.(4)Multi-factorial logistic regression results showed that women with a first birth were 1.6 times more likely to have an adverse pregnancy outcome compared to women who had experienced childbirth(OR 1.568,95% CI 1.125-2.185).Regarding the trajectory of anxiety development during pregnancy,women in the "mild anxiety group" were1.5 times more likely to have an adverse pregnancy outcome than those in the "no anxiety group"(OR 1.529,95% CI 1.062-2.200).Conclusion: In Chongqing,women have a relatively high incidence of adverse pregnancy outcomes.The levels of occurrence of stress and anxiety during pregnancy were at the national average,and the incidence of depression was low.The levels of stress,anxiety,and depression throughout pregnancy tended to decrease with the duration of pregnancy.Anxiety symptoms at first birth and persist throughout pregnancy put women at a higher risk of adverse pregnancy outcomes.It is recommended that increased attention should be given to women’s mental health throughout pregnancy.Timely management of the various negative psychological emotions that women may experience during pregnancy is recommended in order to reduce the incidence of adverse pregnancy outcomes.