Psychosocial Factors and Prevalence of Stress in Early Pregnancy: A Study in Makassar City
Abstract
Stress during pregnancy can negatively impact the health of both the mother and the fetus, especially in the first trimester, which is a period of intense physical and emotional adaptation. This study aims to determine the prevalence and psychosocial factors associated with the occurrence of stress in first-trimester pregnant women in Makassar City. This study uses a cross-sectional design involving 256 first-trimester pregnant women from five public health centers in the suburban areas of Makassar City. Data were collected through interviews using a structured questionnaire. The Edinburgh Postnatal Depression Scale (EPDS10) instrument was used to measure stress levels. Analysis was conducted bivariately and multivariately using logistic regression. The prevalence of severe stress among pregnant women in the first trimester was 36.72%. Multivariate analysis revealed two factors significantly associated with severe stress: low family income (adjusted Prevalence Ratio (aPR) = 2.32; 95% CI: 1.15–4.66; p = 0.018) and poor interpersonal relationships with parents or in-laws (adjusted Prevalence Ratio (aPR) = 4.63; 95% CI: 1.53–14.02; p = 0.007). Socioeconomic factors and interpersonal relationships with parents/in-laws influence the high levels of stress experienced by first-trimester pregnant women. Early intervention that considers the family's economic aspects and social support from the surrounding environment is critical in preventing stress during pregnancy.
Full text article
References
1. Dipietro JA. Psychological and Psychophysi-ological Considerations Regarding the Maternal-Fetal Relationship. Infant and Child Development. 2010;19(1):27–38. https://doi.org/10.1002/icd.651
2. WHO. Perinatal Mental Health. Geneva; Word Health Organization. https://www.who.int/teams/mental-health-and-substance-use/promotion-prevention/maternal-mental-health
3. Manuaba F. Ilmu Kebidanan, Penyakit Kandungan, dan KB untuk Pendidikan Bidan. 2nd ed. Jakarta: EGC; 2010.
4. Belay YA, Moges NA, Hiksa FF, Arado KK, Liben ML. Prevalence of Antenatal Depression and Associated Factors among Pregnant Women Attending Antenatal Care at Dubti Hospital: A Case of Pastoralist Region in Northeast Ethiopia. Depression Research and Treatment. 2018;2018(1). https://doi.org/10.1155/2018/1659089
5. Bödecs T, Szilágyi E, Cholnoky P, Sándor J, Gonda X, Rihmer Z, et al. Prevalence and Psychosocial Background of Anxiety and Depression Emerging During the First Trimester of Pregnancy: Data from a Hungarian Population-Based Sample. Psychiatria Danubina. 2013;25(4):352–358. https://pubmed.ncbi.nlm.nih.gov/24247046/
6. Yang K, Wu J, Chen X. Risk Factors of Perinatal Depression in Women: A Systematic Review and Meta-Analysis. BMC Psychiatry. 2022;22(1):63. https://doi.org/10.1186/s12888-021-03684-3
7. Dunkel Schetter C, Tanner L. Anxiety, Depression and Stress in Pregnancy: Implications for Mothers, Children, Research, and Practice. Current Opinion in Psychiatry. 2012;25(2):141–148. https://doi.org/10.1097/YCO.0b013e3283503680
8. Gelaye B, Rondon MB, Araya R, Williams MA. Epidemiology of Maternal Depression, Risk Factors, and Child Outcomes in Low-Income and Middle-Income Countries. The Lancet Psychiatry. 2016;3(10):973-982. https://doi.org/10.1016/S2215-0366(16)30284-X
9. Răchită A, Strete GE, Suciu LM, Ghiga DV, Sălcudean A, Mărginean C. Psychological Stress Perceived by Pregnant Women in the Last Trimester of Pregnancy. International Journal of Environmental Research and Public Health. 2022;19(14):8315. https://www.mdpi.com/1660-4601/19/14/8315
10. Dosani A, Yim IS, Shaikh K, Lalani S, Alcantara J, Letourneau N, et al. Psycho-metric Analysis of the Edinburgh Postnatal Depression Scale and Pregnancy Related Anxiety Questionnaire in Pakistani Pregnant Women. Asian Journal of Psychiatry. 2022;72:103066. https://doi.org/10.1016/j.ajp.2022.103066
11. Dhaliwal SK, Dabelea D, Lee-Winn AE, Crume T, Wilkening G, Perng W. Maternal Psychosocial Stress During Pregnancy and Offspring Neurobehavioral Outcomes During Early Childhood in the Healthy Start Study. Annals of Epidemiology. 2023;86:16-24. https://doi.org/10.1016/j.annepidem.2023.06.001
12. Padhani ZA, Salam RA, Rahim KA, Naz S, Zulfiqar A, Ali Memon Z, et al. Prevalence and Risk Factors of Perinatal Depression Among Mothers and Fathers in Pakistan: A Systematic Review and Meta-Analysis. Health Psychology and Behavioral Medicine. 2024;12(1). https://doi.org/10.1080/21642850.2024.2383468
13. Atif M, Halaki M, Raynes‐Greenow C, Chow C. Perinatal Depression in Pakistan: A Systematic Review and Meta‐Analysis. Birth. 2021;48(2):149–163. https://doi.org/10.1111/birt.12535
14. Chíxaro L, Soroka V, Moreira P, Duran T, Neto E, Veras M. Efeitos Do Estresse E Da Saúde Mental Materna Na Gravidez: Uma Revisão de Literatura: Effects of Stress and Maternal Mental Health on Pregnancy: A Literature Review. Revista Científica Multidisciplinar O Saber. 2024;1(2):1-9. https://doi.org/10.51473/rcmos.v1i2.2024.725
15. Khanam R, Applegate J, Nisar I, Dutta A, Rahman S, Nizar A, et al. Burden and Risk Factors for Antenatal Depression and Its Effect on Preterm Birth in South Asia: A Population-Based Cohort Study. PLoS ONE. 2022;17(2):e0263091. https://doi.org/10.1371/journal.pone.0263091
16. Waqas A, Zubair M, Zia S, Meraj H, Aedma KK, Majeed MH, et al. Psychosocial Predictors of Antenatal Stress in Pakistan: Perspectives from a Developing Country. BMC Research Notes. 2020;13(160). https://doi.org/10.1186/s13104-020-05007-3
17. Madeghe BA, Kogi-Makau W, Ngala S, Kumar M. Risk Factors and Experiences of Prepartum Depression in Urban-Low-Income Settlement Nairobi Kenya: A Mixed-Method Study. F1000Research. 2020;9: 1495. https://doi.org/10.12688/f1000research.27434.3
18. Oliveira TA, Luzetti GGCM, Rosalém MMA, Mariani Neto C. Screening of Perinatal Depression Using the Edinburgh Postpartum Depression Scale. Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):452–457. https://doi.org/10.1055/s-0042-1743095
19. Qiftiyah K, Azizah N. Bridging Communication Gaps for Maternal Well-Being. Academia Open. 2024;9(2). https://doi.org/10.21070/acopen.9.2024.8310
Authors
Copyright (c) 2025 by author
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Atribusi-NonKomersial-BerbagiSerupa 4.0 Internasional License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Copyright encompasses rights to reproduce and deliver the article in all form and media, including reprints, photographs, microfilms and any other similar reproductions, as well as translations. The reproduction of any part of this journal, its storage in databases and its transmission by any form or media, such as electronic, electrostatic and mechanical copies, photocopies, recordings, magnetic media, etc.
All articles published Open Access are free for everyone to read and download. Under the CC-BY-NC-SA license, authors retain ownership of the copyright for their article, but authors grant others permission to use the content of publications in Media Kesehatan Masyarakat Indonesia Universitas Hasanuddin in whole or in part provided that the original work is properly cited. Users (redistributors) of Media Kesehatan Masyarakat Indonesia Universitas Hasanuddin are required to cite the original source, including the author's names, Media Kesehatan Masyarakat Indonesia Universitas Hasanuddin as the initial source of publication, year of publication, and volume number.
Media Kesehatan Masyarakat Indonesia Universitas Hasanuddin is licensed under Creative Commons Atribusi-NonKomersial-BerbagiSerupa 4.0 Internasional.