title: Associations between maternal characteristics and pregnancy-related stress among low-risk mothers: an observational cross-sectional study.
abstract: BACKGROUND
  Pregnancy is viewed as a major life event and, while the majority of healthy, low-risk women adapt well to pregnancy, there are those whose levels of stress are heightened by the experience.
  
  
  OBJECTIVE
  To determine the level of pregnancy-related stress experienced by a group of healthy, low-risk pregnant women and to relate the level of stress with a number of maternal characteristics.
  
  
  METHODS
  An observational cross-sectional study.
  
  
  METHODS
  A large, urban maternity centre in Northern Ireland.
  
  
  METHODS
  Of the 306 pregnant women who were invited to participate, 278 provided informed consent and were administered one self-complete questionnaire. Due to the withdrawal criteria, 15 questionnaires were removed from the analysis, resulting in a final sample of 263 healthy, low-risk pregnant women.
  
  
  METHODS
  Levels of stress were measured using a self-report measure designed to assess specific worries and concerns relating to pregnancy. Maternal characteristics collected included age, marital status, social status, parity, obstetric history, perceived health status and 'wantedness' for the pregnancy. Regression analysis was undertaken using an ordinary linear regression model.
  
  
  RESULTS
  The mean prenatal distress score in the sample was 15.1 (SD=7.4; range 0-46). The regression model showed that women who had had previous pregnancies, with or without complications, had significantly lower mean prenatal distress scores than primiparous women (p<0.01). Women reporting poorer physical health had higher mean prenatal distress scores than those who reported at least average health, while women aged 16-20 experienced a mean increase in the reported prenatal distress score (p<0.05) in comparison to the reference group of 36 years and over.
  
  
  CONCLUSIONS
  This study brings to light the prevalence of pregnancy-related stress within a sample representative of healthy, low-risk women. Current antenatal care is ill-equipped to identify women suffering from high levels of stress; yet a growing body of research evidence links stress with adverse pregnancy outcomes. This study emphasises that healthy, low-risk women experience a range of pregnancy-related stress and identification of stress levels, either through the use of a simple stress measurement tool or through the associated factors identified within this research study, provides valuable data on maternal well-being.
authors.affiliation: School of Nursing & Midwifery, Queen's University Belfast BT17 9JY, United Kingdom. f.lynn@qub.ac.uk
authors.forename: Fiona A
authors.initials: FA
authors.lastname: Lynn
authors.forename: Fiona A
authors.initials: FA
authors.lastname: Alderdice
authors.forename: Grainne E
authors.initials: GE
authors.lastname: Crealey
authors.forename: James C
authors.initials: JC
authors.lastname: McElnay
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D009035:Mothers / Q000523:psychology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology*; D055815:Young Adult