Stress and resilience during pregnancy: A comparative study between pregnant and non-pregnant women in Ethiopia

TY - JOUR

T1 - Stress and resilience during pregnancy

T2 - A comparative study between pregnant and non-pregnant women in Ethiopia

AU - Abera, Mubarek

AU - Hanlon, Charlotte

AU - Fedlu, Hikma

AU - Fewtrell, Mary

AU - Tesfaye, Markos

AU - Wells, Jonathan C K

N1 - CH receives support from the National Institute of Health Research through the NIHR Global Health Research Group on Homelessness and Mental Health in Africa (NIHR134325) and the SPARK project (NIHR200842) using UK aid from the UK Government. CH receives support from the Wellcome Trust through grants 222154/Z20/Z and 223615/Z/21/Z.

PY - 2023/5/22

Y1 - 2023/5/22

N2 - BackgroundStress during pregnancy is associated with perturbances in maternal psychology and physiology,and results in adverse pregnancy and birth outcomes. However, little attention hasbeen given to understand maternal stress and its potential negative consequences in manylow- and middle-income countries. We aimed to investigate whether pregnancy is associatedwith greater stress and lower psychological resilience among women living in Jimma,Southwest Ethiopia.MethodAn institution-based comparative cross-sectional study design was implemented in JimmaUniversity Medical Center and Jimma health centers from 15 September to 30 November2021. Women attending antenatal care and family planning services were invited to participatein the study. Participants were interviewed using the Perceived Stress Scale (PSS-10),Brief Resilience Scale (BRS), distress questionnaire-5, and the Household Food InsecurityAccess Scale (HFIAS). Linear regression analysis was used to test associations betweenpregnancy (exposure) and outcomes of interest (stress and resilience scores), while adjustingfor potential confounders. Stress and resilience were mutually adjusted for one anotherin the final model.ResultsA total of 166 pregnant and 154 non-pregnant women participated, with mean age of 27.0SD 5.0 and 29.5 SD 5.3 years respectively. Pregnancy was associated with increasedstress score by 4.1 points (β = 4.1; 95% CI: 3.0, 5.2), and with reduced resilience by 3.3 points (β = -3.3; 95% CI: -4.5, -2.2) in a fully adjusted model. In mutually-adjusted models,pregnancy was independently associated with greater stress (β = 2.9, 95% CI 1.8, 3.9) andlower resilience (β = -1.3, 95% CI: -2.5, -0.2) compared to non-pregnant women.ConclusionIn this low income setting, pregnancy is associated with greater vulnerability in the mentalhealth of women, characterized by greater perceived stress and diminished resilience. Context-relevant interventions to improve resilience and reduce stress could help improve thehealth and wellbeing of mothers, with potential benefits for their offspring.

AB - BackgroundStress during pregnancy is associated with perturbances in maternal psychology and physiology,and results in adverse pregnancy and birth outcomes. However, little attention hasbeen given to understand maternal stress and its potential negative consequences in manylow- and middle-income countries. We aimed to investigate whether pregnancy is associatedwith greater stress and lower psychological resilience among women living in Jimma,Southwest Ethiopia.MethodAn institution-based comparative cross-sectional study design was implemented in JimmaUniversity Medical Center and Jimma health centers from 15 September to 30 November2021. Women attending antenatal care and family planning services were invited to participatein the study. Participants were interviewed using the Perceived Stress Scale (PSS-10),Brief Resilience Scale (BRS), distress questionnaire-5, and the Household Food InsecurityAccess Scale (HFIAS). Linear regression analysis was used to test associations betweenpregnancy (exposure) and outcomes of interest (stress and resilience scores), while adjustingfor potential confounders. Stress and resilience were mutually adjusted for one anotherin the final model.ResultsA total of 166 pregnant and 154 non-pregnant women participated, with mean age of 27.0SD 5.0 and 29.5 SD 5.3 years respectively. Pregnancy was associated with increasedstress score by 4.1 points (β = 4.1; 95% CI: 3.0, 5.2), and with reduced resilience by 3.3 points (β = -3.3; 95% CI: -4.5, -2.2) in a fully adjusted model. In mutually-adjusted models,pregnancy was independently associated with greater stress (β = 2.9, 95% CI 1.8, 3.9) andlower resilience (β = -1.3, 95% CI: -2.5, -0.2) compared to non-pregnant women.ConclusionIn this low income setting, pregnancy is associated with greater vulnerability in the mentalhealth of women, characterized by greater perceived stress and diminished resilience. Context-relevant interventions to improve resilience and reduce stress could help improve thehealth and wellbeing of mothers, with potential benefits for their offspring.

U2 - 10.1371/journal.pgph.0001416

DO - 10.1371/journal.pgph.0001416

M3 - Article

SN - 2767-3375

JO - PLOS Global Public Health

JF - PLOS Global Public Health

ER -