title: Antenatal stress: an Irish case study.
abstract: BACKGROUND
  stress in pregnancy is common and impacts negatively on women, infants and families. A number of factors contribute to high levels of stress in pregnancy, including financial concerns, marital discord, low support systems and low socio-economic status.
  
  
  OBJECTIVE
  the aim of this study was to evaluate stress anxiety levels and depressive symptoms among low risk women in an area in Ireland that was particularly impacted by the 2008 economic crisis.
  
  
  METHODS
  a quantitative descriptive cross-sectional design was used. Data were collected using the Edinburgh Postnatal Depression Scale (EPDS), the Perceived Stress Scale and the State Trait Anxiety Inventory (STAI). Data was collected at a single time during the second trimester.
  
  
  METHODS
  this paper reports a case study of one maternity service in Ireland. Participants included low risk pregnant women who were attending the hospital clinic for routine antenatal care.
  
  
  RESULTS
  of 150 questionnaires distributed, 74 completed questionnaires were returned indicating a 49.3% return rate. Findings indicated high levels of stress, anxiety and depressive symptomatology among participants. There were no significant difference in mean EPDS score for different age groups (F4,69=2.48, P=0.052), living arrangements (F4,68=0.90, P=0.5) or usual occupation (F4,69=1.45, P=0.2). A score of ≥ 12 was taken as indicative of probable antenatal depression and 86.5% of participants responded with a score of 12 or above. PSS scores were also high and more than three quarters of respondents scored ≥ 15 (75.6%) and more than a third had scores ≥ 20 (35.1%), out of a total score of 40. There was a significant difference in mean PSS score between the different age groups (F4,69=3.60, P=0.010) but not for living arrangements or usual occupation. A STAI score of ≥ 39 was taken as indicative of antenatal anxiety, and 74.3% of participants responded with a score of 39 or above. There were no significant differences in mean STAI score between the different age groups (F4,68=1.68, P=0.16), living arrangements (F4,67=2.30, P=0.068) or usual occupations (F4,68=1.25, P=0.3).
  
  
  CONCLUSIONS
  this study found high levels of antenatal stress, anxiety, and depressive symptoms in a low risk pregnant population, in an economically impacted region in Ireland. These findings have implications for fetal development and maternal health during pregnancy and in the post partum. Further studies are important to confirm rates and should be conducted over a longer time frame with data collected at more than one point in time, such as mid and late pregnancy. If findings are confirmed, early recognition and treatment of stress, anxiety and depressive symptoms is important to ameliorate some of the harmful effects of these conditions.
authors.affiliation: School of Nursing and Midwifery, St Alban's Campus, Victoria University, PO Box 14228, Melbourne 8001, Australia. Electronic address: Mary.carolan@vu.edu.au.
authors.forename: Mary
authors.initials: M
authors.lastname: Carolan-Olah
authors.affiliation: Department of Nursing & Midwifery, Health Science Building, Northbank Campus, University of Limerick, Ireland, UK. Electronic address: maebh.barry@ul.ie.
authors.forename: Maebh
authors.initials: M
authors.lastname: Barry
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D019052:Depression, Postpartum / Q000451:nursing / Q000523:psychology*; D005260:Female; D006801:Humans; D007494:Ireland; D011247:Pregnancy; D011248:Pregnancy Complications / Q000451:nursing / Q000523:psychology*; D011295:Prenatal Care; D011569:Psychiatric Status Rating Scales; D012959:Socioeconomic Factors; D013315:Stress, Psychological; D055815:Young Adult
keywords: Anxiety; Depressive symptoms; Pregnancy; Stress