Perceived stress and associated factors in pregnant women: a cross-sectional study nested within a population-based cohort

Lopes, Bárbara Cerqueira Santos; Lima, Cássio de Almeida; Ferreira, Talyta Sâmara Batista; Freitas, Wesley Miranda Lourenço de; Ferreira, Thalita Bahia; Pinho, Lucineia de; Brito, Maria Fernanda Santos Figueiredo; Silveira, Marise Fagundes

doi:10.1590/1806-9304202300000169-en

person Bárbara Cerqueira Santos Lopes

conception and design of the study · data collection · drafting of the manuscript · approved the final version of the article · declaration of no conflict of interest

schoolPostgraduate Program in Health Sciences. Center for Biological and Health Sciences. State University of Montes Claros. Av. Prof. Rui Braga, s.n. Vila Mauricéia. University Campus Prof. Darcy Ribeiro. Montes Claros, MG, Brazil. CEP: 39.401-089. Email: cassioenf2014@gmail.com

0000-0002-7617-2218

person Cássio de Almeida Lima

conception and design of the study · data collection · drafting of the manuscript · approved the final version of the article · declaration of no conflict of interest

schoolPostgraduate Program in Health Sciences. Center for Biological and Health Sciences. State University of Montes Claros. Av. Prof. Rui Braga, s.n. Vila Mauricéia. University Campus Prof. Darcy Ribeiro. Montes Claros, MG, Brazil. CEP: 39.401-089. Email: cassioenf2014@gmail.com

0000-0002-4261-8226

person Talyta Sâmara Batista Ferreira

conception and design of the study · data collection · drafting of the manuscript · approved the final version of the article · declaration of no conflict of interest

schoolPostgraduate Program in Health Sciences. Center for Biological and Health Sciences. State University of Montes Claros. Av. Prof. Rui Braga, s.n. Vila Mauricéia. University Campus Prof. Darcy Ribeiro. Montes Claros, MG, Brazil. CEP: 39.401-089. Email: cassioenf2014@gmail.com

0000-0002-1342-4799

person Wesley Miranda Lourenço de Freitas

conception and design of the study · data collection · drafting of the manuscript · approved the final version of the article · declaration of no conflict of interest

schoolDepartament of Medicine. Center for Biological and Health Sciences. State University of Montes Claros. Montes Claros, MG, Brazil.

0000-0001-9764-4897

person Thalita Bahia Ferreira

conception and design of the study · data collection · drafting of the manuscript · approved the final version of the article · declaration of no conflict of interest

schoolDepartament of Medicine. Center for Biological and Health Sciences. State University of Montes Claros. Montes Claros, MG, Brazil.

0000-0001-6764-3463

person Lucineia de Pinho

conception and design of the study · supervision of data collection · data analysis and interpretation · critical revision of the manuscript · approved the final version of the article · declaration of no conflict of interest

schoolDepartment of Mental Health and Collective Health. Center for Biological and Health Sciences. State University of Montes Claros. Montes Claros, MG, Brazil.

0000-0002-2947-5806

person Maria Fernanda Santos Figueiredo Brito

conception and design of the study · supervision of data collection · data analysis and interpretation · critical revision of the manuscript · approved the final version of the article · declaration of no conflict of interest

schoolDepartment of Mental Health and Collective Health. Center for Biological and Health Sciences. State University of Montes Claros. Montes Claros, MG, Brazil.

0000-0001-5395-9491

person Marise Fagundes Silveira

conception and design of the study · statistical analysis, and interpretation of data · critical revision of the manuscript · approved the final version of the article · declaration of no conflict of interest

schoolDepartment of Exact Sciences. Exact and Technological Sciences Center. State University of Montes Claros. Montes Claros, MG, Brazil.

0000-0002-8821-3160

Associated Editor: Alex Sandro Souza

Variables	n*	%
Sociodemographic characteristics
Age group (years)
Up to 19	194	16.1
20-35	873	72.4
Over 36	138	11.5
Marital status
Without partner	297	23.3
With partner	979	76.7
Education
Elementary school incomplete	121	9.5
Elementary school complete	73	5.7
High School incomplete	200	15.7
High School Complete	629	49.3
Higher education incomplete	89	7.0
Higher education complete	165	12.9
Family income (minimum wage)
Above two salaries	431	35.2
One to two salaries	479	39.1
Below one salary	316	25.7
Receives Bolsa Família assistance
Yes	268	21.0
No	1009	79.0
Family functioning
Dysfunctional family	211	16.6
Functional family	1062	83.4
Social Support
Low social support	237	18.8
High social support	1024	81.2
Obstetric Characteristics
Gestational trimester
Third trimester	422	33.0
Second trimester	515	40.3
First trimester	341	26.7
Current pregnancy planning
Yes	503	40.0
No	754	60.0
Parity
Nullipara	607	48.6
Primipara	392	31.4
Multiparous	249	20.0
Health conditions
Urinary Infection
Yes	254	20.0
No	1017	80.0
Gestational diabetes
Yes	69	5.4
No	1204	94.6
Anemia
Yes	147	11.6
No	1125	88.4
Bleeding
Yes	40	3.1
No	1233	96.9
Pregnancy hypertensive syndromes
Yes	49	3.8
No	1225	96.2
Migraine
Yes	166	13.1
No	1100	86.9
Stress level
High-Stress Level	304	24.2
Low-stress level	954	75.8
Anxiety symptoms
High anxiety level	547	45.4
Low level of anxiety	657	54.6
Depression symptoms
Major depressive symptoms	314	25.3
Moderate depressive symptoms	201	16.2
No depressive symptoms	728	58.6
Main complaints
Sleep alterations
Yes	914	71.6
No	362	28.4
Cardiovascular
Yes	839	65.6
No	440	34.4
Cutaneous
Yes	602	47.1
No	677	52.9
Gastrointestinal
Yes	1225	95.8
No	54	4.2
Genitourinary
Yes	997	78.0
No	282	22.0
Mammary
Yes	715	56.2
No	558	43.8
Musculoskeletal
Yes	1001	78.3
No	278	21.7
Neurological
Yes	1017	79.5
No	262	20.5
Respiratory
Yes	752	59.8
No	506	40.2
Weakness/dizziness/fainting
Yes	923	72.2
No	356	27.8

Variables	Stress level				p*
	Down		High
	n	%	n	%
Sociodemographic characteristics
Age group (years)					<0.001
Up to 19	128	67.0	63	33.0
20-35	681	79.1	180	20.9
Over 36	91	66.9	45	33.1
Income (minimum wage)					0.253
Above two salaries	346	81.6	78	18.4
One to two salaries	355	75.5	115	24.5
Below one salary	214	68.4	99	31.6
Education					<0.001
Incomplete elementary school	74	62.7	44	37.3
Elementary school complete	50	71.4	20	28.6
High school incomplete	134	68.0	63	32.0
High school complete	494	79.5	127	20.5
Higher education incomplete	66	75.9	21	24.1
Higher education complete	135	82.8	28	17.2
Marital status					<0.001
Without partner	195	66.8	97	33.2
With partner	758	78.7	205	21.3
Receives Bolsa Família assistance					0.015
Yes	183	70.4	77	29.6
No	769	77.2	227	22.8
Family functioning					<0.001
Dysfunctional family	112	55.4	90	44.6
Functional family	837	79.6	214	20.4
Social Support					<0.001
Low social support	125	53.0	111	47.0
High social support	947	75.8	302	24.2
Obstetric Characteristics
Gestational trimester					0.498
Third trimester	325	77.6	94	22.4
Second trimester	382	75.6	123	24.4
First trimester	246	73.9	87	26.1
Current pregnancy planning					<0.001
Yes	417	83.2	84	16.8
No	525	71.1	213	28.9
Parity					0.002
Nullipara	470	78.6	128	21.4
Primipara	298	77.2	88	22.4
Multiparous	166	67.2	81	32.8
Health conditions
Urinary Infection					0.001
Yes	170	67.7	81	32.3
No	779	77.8	222	22.2
Gestational diabetes
Yes	47		22	31.9	0.084
No	904	76.3	281	23.7
Anemia					0.012
Yes	99	67.8	47	32.2
No	851	76.9	255	23.1
Bleeding					0.079
Yes	26	65.0	14	35.0
No	925	762	289	23.8
Pregnancy hypertensive syndromes					0.279
Yes	35	71.4	14	28.6
No	917	76.0	289	24.0
Migraine					0.010
Yes	110	67.9	52	32.1
No	835	76.9	251	23.1
Anxiety symptoms					<0.001
Low level of anxiety	529	80.8	126	19.2
High level of anxiety	371	68.7	169	31.3
Depressive symptoms					<0.001
Severe symptoms	138	44.2	174	55.8
Moderate symptoms	139	69.8	60	30.2
No symptoms	660	91.3	63	8.7
Main complaints
Sleep alterations					<0.001
Yes	655	62.7	246	27.3
No	298	83.9	57	16.1
Cardiovascular					0.001
Yes	501	74.3	173	25.7
No	348	81.1	81	18.9
Cutaneous					0.025
Yes	432	73.2	158	26.8
No	522	78.1	146	21.9
Gastrointestinal					0.138
Yes	910	75.5	295	24.5
No	44	83.0	9	17.0
Genitourinary					<0.001
Yes	719	73.1	264	26.9
No	235	85.5	40	14.5
Mammary					0.300
Yes	527	74.8	178	25.2
No	425	77.3	125	22.7
Musculoskeletal					0.263
Yes	744	75.4	243	24.6
No	210	77.5	61	22.5
Neurological					<0.001
Yes	733	73.2	269	26.8
No	221	86.3	35	13.7
Respiratory					<0.001
Yes	539	71.7	213	28.3
No	415	82.0	91	18.0
Weakness/dizziness/fainting					<0.001
Yes	657	72.1	254	27.9
No	297	85.6	50	14.4

Variables	Stress level		p
Variables	Gross PR (CI95%)	Adjusted PR (CI95%)*	p
Sociodemographic characteristics
Age group (years)			0.001
Over 35	1.58 (1.21-2.08)	1.38 (1.09 -1.74)
Under or equal to 19	1.58 (1.24-2.00)	1.41 (1.13-1.77)
From 20 to 35	1.00	1.00
Marital status			0.005
Without partner	1.56 (1.27-1.91)	1.33 (1.09-1.62)
With partner	1.00	1.00
Social support			<0.001
Low social support	2.50 (2.07-3.00)	1.42 (1.18-1.70)
High social support	1.00	1.00
Obstetric variables
Planned pregnancy			0.005
No	1.72 (1.37-2.16)	1.23 (1.00-1.52)
Yes	1.00	1.00
Parity			0.004
Multi-pair	1.53 (1.21-1.94)	1.30 (1.02-1.66)
Primipara	1.07 (0.84-1.35)	1.06 (0.85-1.33)
Nullipara	1.00	1.00
Health conditions
Urinary infection			0.001
Yes	1.50 (1.18-1.80)	1.35 (1.12-1.62)
No	1.00	1.00
Anxiety symptoms			<0.001
High Anxiety Level	1.63 (1.33-1.99)	1.42 (1.18-1.71)
Low level of anxiety	1.00	1.00
Depressive symptoms			<0.001
Severe symptoms	6.40 (4.96-8.27)	4.74 (3.60-6.26)
Moderate symptoms	3.46 (2.52-4.75)	3.19 (2.31-4.39)
No symptoms	1.00	1.00
Main complaints during gestation Neurological			<0.001
Yes	1.96 (1.42-2.72)	1.77 (1.27-2.47)
No	1.00	1.00

[TFN1] Minimum wage: R$ 954.00; *Totals vary due to missing information.

Perceived stress and associated factors in pregnant women: a cross-sectional study nested within a population-based cohort

Abstract