Psychological distress profiles in expectant mothers: What is the association with pregnancy-related and relational variables?

Abstract

Introduction: Research has progressively focused on antenatal psychological disease of expectant mothers, showing that anxiety and depression as well as fear of childbirth occur frequently during pregnancy. Some studies have investigated the connection between anxiety, depression, and fear of childbirth with contrasting results. Several authors have analyzed the association between psychological disease of pregnant women and numerous medical-obstetric and relational variables, still reporting inconclusive findings. The present study had three aims: 1) to investigate the psychological well-being of pregnant women based on their levels of anxiety, depression, and fear of childbirth, by identifying psychological profiles; (2) to analyze the association between the emergent psychological profiles and some medical-obstetric variables related to pregnancy; and (3) to examine the association between these profiles and couple's adjustment and social support.

Methods: 410 Italian primiparous pregnant women in the 7th-8th month of pregnancy completed a questionnaire packet on site that included the following scales: Wijma Delivery Expectancy Questionnaire, Edinburgh Postnatal Depression Scale, State-Trait Anxiety Inventory, Dyadic Adjustment Scale, Multidimensional Scale of Perceived Social Support.

Results: Findings revealed the presence of three different clusters: "psychologically healthy women" (34.9%), comprised of women characterized by low levels of symptoms on all the scales; "women experiencing pregnancy- and childbirth-related anxiety" (47.3%), which groups women with an average state anxiety over the clinical value; and "psychologically distressed women" (17.8%), comprised of women who reported high levels of symptoms on all the scales, some above the clinical cut-offs. These profiles were not related to the medical-obstetric variables. On the other hand, findings revealed a significant association between marital adjustment as well as social support and cluster membership.

Discussion: These results support the importance of early and multilevel psychological screening in order to understand the experience of pregnant women and to develop targeted and increasingly personalized interventions.