In Summary

• Women in their second pregnancy showed high levels of psychological distress: More than 84% experienced moderate anxiety and more than 90% reported moderate-to-high perceived stress, in a study of 400 participants in Egypt.
• Low psychological capital, identified in 71% of the women, significantly increased vulnerability to anxiety and stress, suggesting that interventions to strengthen positive psychological resources could be a key strategy for improving maternal mental health outcomes in subsequent pregnancies.

Context

• Prenatal anxiety and stress are well-recognized challenges to psychological well-being during pregnancy, with reported prevalences ranging from 6% to 57% for anxiety and 25% to 75% for stress. These conditions pose significant risks to maternal and fetal health. Maternal anxiety and stress have been linked to adverse outcomes, such as increased risk of up to 80% for miscarriage, preterm birth, and fetal death.
• Women in their second pregnancy are expected to adapt better psychologically because of prior experience and greater awareness of their first pregnancy. However, they often face additional pressures from family, work, and social responsibilities and are generally older than first-time mothers.
• Psychological capital represents an individual positive resource that can be developed and sustained to improve well-being and performance. It comprises four key components, namely, self-efficacy (confidence), optimism (positive attribution), hope (goal perseverance), and resilience (the ability to endure and overcome challenges).
• Previous studies have reported that positive psychological capital plays a crucial role in alleviating pregnancy-associated psychological stress, highlighting its potential as a protective factor against prenatal anxiety and stress.

Methodology

• Researchers conducted a descriptive, correlational study involving 400 women attending antenatal clinics in Port Said, Egypt, all of whom were expecting their second child and were aged 18-40 years.
• Participants completed structured interviews using the Self-Rating Anxiety Scale to assess anxiety, the Perceived Stress Scale to measure perceived stress, and the Psychological Capital Questionnaire to evaluate psychological capital.
• Data were collected through in-person interviews over a 5-month period in 2024, with these interviews taking approximately 10-15 minutes per participant to complete all questionnaires.
• Inclusion criteria were adult women without chronic medical conditions who were between 12 and 38 weeks’ gestation, had a singleton pregnancy, and were literate. Women in active labor or with a personal or family history of diagnosed mental disorders were excluded.

Takeaway

• Perceived stress and anxiety showed a significant positive correlation (P < .01), whereas psychological capital demonstrated significant negative correlations with both anxiety and perceived stress (P < .01), indicating that higher levels of psychological capital are associated with lower levels of psychological distress.
• Eight variables were identified as significant predictors of psychological capital during the second pregnancy (P < .05), namely, maternal age, employment status, husband’s university education, monthly income, planned pregnancy, fetal sex preference, receipt of prenatal information, and a history of cesarean delivery.
• Five factors emerged as significant predictors of anxiety levels in women in a second pregnancy (P < .05), namely, perceived quality of healthcare, planned pregnancy, fear related to childbirth, time since the last delivery, and psychological capital, with psychological capital showing a protective effect.
• Preference for the fetus’s sex, history of cesarean delivery, psychological capital, and anxiety scores were the main predictors that significantly influenced perceived stress levels in this population (P < .05), highlighting the interconnection between psychological and sociocultural factors.

In Practice

“Antenatal interventions that assess and strengthen psychological capital could be key to improving maternal mental health outcomes in subsequent pregnancies,” the study authors wrote.

Source

The study was led by Amal Mahmoud, PhD, Mental Health and Psychiatric Health Nursing Department, Port Said University, Port Said, Egypt. It was published online on January 15 in BMC Pregnancy and Childbirth.

Limitations

The self-reported nature of the assessment tools could introduce social desirability or recall bias, affecting the accuracy of the psychological measurements.

Disclosures

The authors did not receive any external funding for this study. No relevant conflicts of interest or disclosures were reported in the study.

This article was translated from Univadis Italy, part of the Medscape Professional network.