title: Comparison of Pregnancy Stress Between In Vitro Fertilization/Embryo Transfer and Spontaneous Pregnancy in Women During Early Pregnancy.
abstract: BACKGROUND
  Women who undergo in vitro fertilization/embryo transfer (IVF/ET) face complicated psychological stress and negative emotions, which may affect health during pregnancy and the development of the fetus. The current literature does not address the question of whether women who become pregnant spontaneously and women who undergo IVF face similar levels of pregnancy stress.
  
  
  OBJECTIVE
  This study investigates the differences in pregnancy stress between women with spontaneous pregnancy and women with IVF/ET pregnancy living in central Taiwan during their first 20 weeks of pregnancy.
  
  
  METHODS
  A prospective, longitudinal design with repeated measures, generalized estimated equations model, Wilks' λ, and Bonferroni test was used. Purposive samples of 163 women who had undergone IVF/ET and of 94 women who had undergone spontaneous pregnancy were enrolled as participants. Pregnancy stress was measured using the Chinese version of the self-administered Pregnancy Stress Scale at the 9th, 12th, and 20th weeks of pregnancy.
  
  
  RESULTS
  The psychological stress experienced by IVF participants significantly increased with gestational week during the first 20 weeks of pregnancy (p < .01) but did not significantly increase in spontaneous-pregnancy participants. Gestational week was the main factor found to influence stress ratings for "identifying maternal role." "Altering body structure and body function" was the main factor found to influence pregnancy stress (p < .00). The method of becoming pregnant had no significant influence on pregnancy stress during the first 20 weeks of pregnancy (p > .05).
  
  
  CONCLUSIONS
  The results of this study provide clinical evidence that IVF/ET does not cause more stress for women than spontaneous pregnancy. However, the intensity and trend of stresses differed between these two groups. These findings suggest that nurses should consider method of pregnancy when assessing the risk of stress in expectant mothers for each gestational week and when providing appropriate care and support.
authors.affiliation: 1MSN, RN, Instructor and Doctoral Student, School of Nursing, College of Medicine, Chung Shan Medical University, and Research Adviser, Department of Nursing, Chung Shan Medical University Hospital 2PhD, RN, Professor, Institute of Allied Health Sciences & School of Nursing, College of Medicine, National Cheng Kung University 3PhD, RN, Assistant Professor, School of Nursing, College of Medicine, Chung Shan Medical University, and Research Adviser, Department of Nursing, Chung Shan Medical University Hospital 4PhD, Assistant Professor, School of Nursing, College of Medicine, Chung Shan Medical University 5PhD, RN, Professor, School of Nursing, College of Medicine, Chung Shan Medical University, and Research Adviser, Department of Nursing, Chung Shan Medical University Hospital 6PhD, MD, Professor, Institute of Medicine, Chung Shan Medical University, and Department of Psychiatry, Chung Shan Medical University Hospital.
authors.forename: Fen-Fen
authors.initials: FF
authors.lastname: Shih
authors.forename: Chung-Hey
authors.initials: CH
authors.lastname: Chen
authors.forename: Chia-Yi
authors.initials: CY
authors.lastname: Chiao
authors.forename: Chi-Rong
authors.initials: CR
authors.lastname: Li
authors.forename: Pi-Chao
authors.initials: PC
authors.lastname: Kuo
authors.forename: Te-Jen
authors.initials: TJ
authors.lastname: Lai
mesh_terms: D000328:Adult; D004624:Embryo Transfer / Q000523:psychology*; D005260:Female; D005307:Fertilization in Vitro / Q000523:psychology*; D006801:Humans; D008137:Longitudinal Studies; D011247:Pregnancy / Q000502:physiology* / Q000523:psychology*; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D011446:Prospective Studies; D013312:Stress, Physiological; D013315:Stress, Psychological; D013624:Taiwan; D055815:Young Adult