The Serbian version of the Pandemic-Related Pregnancy Stress Scale (PREPS-SRB)-A validation study

Pregnancy is a sensitive period in a woman's life when psychological distress can have negative consequences for the mother and fetus. Prolonged and intensified symptoms of anxiety and depression caused by the COVID-19 pandemic increase the risk of maternal and fetal health complications. The Pandemic-Related Pregnancy Stress Scale (PREPS) is a thoroughly designed tool that helps determine and analyze stress among pregnant women during pandemics in three domains: Preparedness in childbirth, (2) Infection, and (3) Positive Appraisal. A cross-sectional study included 189 pregnant women attending a community health center, "Dr Simo Milošević," in Belgrade, Serbia, from January to February 2022. Pregnant women anonymously completed a questionnaire as part of the study. The mean scores for those three domains are as follows: Preparedness (2.4 ± 0.9), Infection stress (2.8 ± 1.1), and Positive Appraisal (3.7 ± 0.9). Internal consistency of the PREPS questionnaire for PREPS-Total (α = 0.867). An explanatory factor analysis of the PREPS showed that the Serbian version of the Pandemic-Related Pregnancy Stress Scale has good psychometric properties. The Kaiser-Meyer-Olkin Measure of Sampling Adequacy (KMO) was found to be 0.860, indicating a high degree of sampling adequacy. Additionally, Bartlett's Test of Sphericity yielded a statistically significant result (χ2 = 1564.206, df = 105, p < 0.001). The CFA showed very good fit indices for the Serbian sample, confirming the factor structure of the original English version. The RMSEA value of 0.056 (0.036-0.075) and values for fit indices TLI (0.961) and CFI (0.974) were above the cut-off of ≥0.95, indicating an excellent fit. All standardized factor loadings were statistically significant and ranged from 0.50 to 0.85. The PREPS-SRB questionnaire serves as a valuable tool for Serbian healthcare professionals, allowing them to identify pregnant women experiencing significant stress related to the COVID-19 pandemic.