title: The impact of resilience on psychological outcomes in women with threatened premature labor and spouses: a cross-sectional study in Southwest China.
abstract: BACKGROUND
  Threatened premature labor (TPL) is a severe obstetric complication which affects the mental and physical health of both the mother and fetus. Family resilience may have protective role against psychological distress in women experiencing these pregnancy complications. There may be resilience related risk factors in TPL women, and interplays may exist among psychological variables and within couples. This study aims to examine psychological outcomes influenced by different levels of resilience, and explore psychological interactions in TPL women, spouses, and between women and spouses.
  
  
  METHODS
  Six validated questionnaires were used to measure the psychological outcomes (Connor-Davidson resilience scale CD-RISC, Edinburgh postnatal depression scale EPDS, positive and negative affect scale PANAS, pregnancy pressure scale PPS, simplified coping style questionnaire SCSQ, social support rating scale SSRS) in 126 TPL women hospitalized in three tertiary hospitals and 104 spouses in Southwest China.
  
  
  RESULTS
  Low resilient women had significantly more complicated placenta praevia, longer pediatric observation, more pressure than high resilient women. They also had significantly less active coping and positive affect, more negative affect and depression compared to high resilient women and their spouses. Although the socio-demographic characteristics of both TPL women and spouses and psychometric parameters of spouses had no significant differences, the prevalence rates of depression in spouses were notable. Compared with spouses, TPL women had a more complex interaction among these psychometric factors, with women's resilience negatively associated with their partners' negative affect, and their pressure positively correlated with pressure and negative affect of spouses.
  
  
  CONCLUSIONS
  Pregnancy complicated with placenta praevia and pediatric observation may be risk factors for resilience of women with TPL. Maternal resilience has an important impact on the psychological outcomes in TPL women. A screening for resilience, depression and other psychological outcomes in couples with TPL and early psychological intervention of low resilient couples may be appropriate to promote resilience and well-being of these families.
authors.affiliation: School of Nursing, Third Military Medical University, No.30 Gaotanyan Street, Chongqing, 400038, China.
authors.forename: Chunhua
authors.initials: C
authors.lastname: Nie
authors.affiliation: Psychological Nursing Office, School of Nursing, Third Military Medical University, No.30 Gaotanyan Street, Chongqing, 400038, China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Dai
authors.affiliation: Department of Cardiology, General Hospital of Shenyang Military Region, No.83 Wenhua Road, Shenyang, 110016, China.
authors.forename: Ren
authors.initials: R
authors.lastname: Zhao
authors.affiliation: Department of Neurosurgery, General Hospital of Shenyang Military Region, No.83 Wenhua Road, Shenyang, 110016, China.
authors.forename: Yushu
authors.initials: Y
authors.lastname: Dong
authors.affiliation: Department of Cardiology, General Hospital of Shenyang Military Region, No.83 Wenhua Road, Shenyang, 110016, China.
authors.forename: Yushan
authors.initials: Y
authors.lastname: Chen
authors.affiliation: School of Nursing, Third Military Medical University, No.30 Gaotanyan Street, Chongqing, 400038, China. renhui__tmmu@163.com.
authors.forename: Hui
authors.initials: H
authors.lastname: Ren
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D007752:Obstetric Labor, Premature / Q000523:psychology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care; D011788:Quality of Life; D055500:Resilience, Psychological; D018454:Spouses / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Depression; Family resilience; Psychological outcomes; Threatened premature labor