title: Effects of prenatal maternal mental distress on birth outcomes.
abstract: BACKGROUND
  Adverse effects of maternal mental distress during pregnancy have been extensively investigated, but the impact of prenatal maternal mental distress at various time periods during pregnancy on birth outcomes is rarely discussed. By understanding the relationship between maternal mental distress and unfavourable birth outcomes throughout pregnancy, appropriate evidence-based preventative care or intervention may be adopted in a timely manner.
  
  
  OBJECTIVE
  This study intended to investigate the effects of maternal stress, anxiety, and depressive symptoms across pregnancy on preterm birth and low birth weight.
  
  
  METHODS
  With a prospective longitudinal design, this study used the 10-item Perceived Stress Scale, Center for Epidemiologic Studies Depression Scale, and Zung Self-reported Anxiety Scale to investigate 197 participants who, at greater than 24 gestational weeks, completed the self-administered questionnaires during regular checkups in a hospital in southern Taiwan. Descriptive statistics, Mann-Whitney U test/Kruskal-Wallis test, and hierarchical logistic regression were applied for data analysis.
  
  
  RESULTS
  The study found that anxiety and depressive symptoms at 25-29 gestational weeks could predict preterm birth, and that anxiety at greater than 30 gestational weeks was able to predict low birthweight. However, stress was not able to predict any kind of negative birth outcomes.
  
  
  CONCLUSIONS
  Adverse birth outcomes were somewhat predictable by maternal mental distress; therefore, we suggested that prenatal visits incorporate psychological assessment for early detection and management to prevent possible adverse birth outcomes.
authors.affiliation: College of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Taiwan.
authors.forename: Shwu-Ru
authors.initials: SR
authors.lastname: Liou
authors.affiliation: Department of Obstetrics and Gynecology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Taiwan.
authors.forename: Panchalli
authors.initials: P
authors.lastname: Wang
authors.affiliation: College of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Taiwan. Electronic address: chingyuus@gmail.com.
authors.forename: Ching-Yu
authors.initials: CY
authors.lastname: Cheng
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D007744:Obstetric Labor Complications / Q000453:epidemiology* / Q000523:psychology; D049590:Postpartum Period / Q000523:psychology*; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology* / Q000523:psychology; D011295:Prenatal Care; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013624:Taiwan; D055815:Young Adult
keywords: Anxiety; Depression; Low birth weight; Premature birth; Stress