Psychological Vulnerability During Pregnancy and Its Obstetric Consequences: A Multidimensional Approach

Area of Science:

• Obstetrics and Gynecology
• Perinatal Mental Health
• Psychological Epidemiology

Background:

• Maternal psychological factors are crucial for perinatal health.
• Routine psychological screening is not standard in Romanian obstetrics.
• The relationship between maternal mental health and adverse obstetric outcomes needs further investigation.

Purpose of the Study:

• To examine the association between maternal depression, anxiety, stress, and resilience and adverse obstetric outcomes in primiparous women.
• To identify key psychological predictors of preterm birth, gestational hypertension, IUGR, and low birth weight.
• To assess the utility of brief psychological screening tools in obstetric care.

Main Methods:

• Cross-sectional study of 240 primiparous women at 20-28 weeks' gestation.
• Utilized Edinburgh Postnatal Depression Scale (EPDS), GAD-7, PSS-10, and CD-RISC-25.
• Correlational and multivariate logistic regression analyses were performed.

Main Results:

• Preterm birth (21%), gestational hypertension (17%), IUGR (15%), and low birth weight (21%) were observed.
• Higher anxiety, stress, and depression scores correlated with adverse outcomes.
• Generalized Anxiety Disorder-7 (GAD-7) was the sole independent predictor of composite adverse obstetric outcomes after adjustment.

Conclusions:

• Generalized anxiety is a significant predictor of adverse obstetric outcomes in primiparous women.
• Perceived stress, depression, and lower resilience also play contributory roles.
• Integrating brief psychological screening tools (GAD-7, PSS-10, CD-RISC-25) into prenatal care can aid early identification and intervention.