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Measuring the ups and downs of pregnancy stress
Abstract
Despite substantial interest in the effects of stress on pregnancy, few instruments are available to measure pregnancy-specific stressors. Moreover, research has typically focused on the distressing, negative aspects of pregnancy. This report examines the reliability and validity of the Pregnancy Experience Scale (PES), a 41-item scale that measures pregnancy-specific daily hassles and uplifts. The PES was administered to two cohorts of low risk women at 24, 30, and 36 weeks (n = 52) or 32 and 38 weeks (n = 137). Women perceived their pregnancies to be significantly more intensely and frequently uplifting than hassling. Internal scale reliability was high (alpha = 0.91 to 0.95). Frequency and intensity scores for hassles and uplifts were stable over time (r's = 0.56 to 0.83) and patterns of convergent and discriminant validity emerged between the PES and existing measures of general affective intensity, daily stressors, depressive symptoms, and anxiety. These results indicate that (1) failure to measure pregnancy-specific stress will underestimate the degree to which pregnant women experience distress and (2) measurement of only the negative aspects of pregnancy will overestimate distress and fail to portray the degree to which women are psychologically elevated by their pregnancies. Measurement of hassles relative to uplifts may provide the most balanced assessment of pregnancy appraisal.
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“Pregnancy anxiety has been suggested to be a more sensitive predictor of birth outcomes than general anxiety (Wadhwa et al., 1993; DiPietro et al., 2004; Roesch et al., 2004; Kramer et al., 2009)”
From High pregnancy anxiety during mid-gestation is associated with decreased gray matter density in 6-9-year-old children. (2010) · cites this paper as DiPietro et al., 2004
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“This is emphasized by observations of pregnancy anxiety having a higher predictive quality for birth outcomes and fetal/child development than general stress scales (Wadhwa et al., 1993; Huizink et al., 2003; DiPietro et al., 2004; Roesch et al., 2004; Dipietro et al., 2006; Kramer et al., 2009; Davis & Sandman, in press)”
From High pregnancy anxiety during mid-gestation is associated with decreased gray matter density in 6-9-year-old children. (2010) · cites this paper as DiPietro et al., 2004
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Loyal, D., Sutter, A.-L., & Rascle, N. (2020) · Maternal and Child Health Journal · doi:10.1007/s10995-020-02885-8 · Cited by 25
Maternal stress in the first 1000 days and risk of childhood obesity: a systematic review
Matvienko‐Sikar, K., Cooney-Quane, J., Flannery, C., Murphy, J., Khashan, A. S., & Huizink, A. C. (2020) · Journal of Reproductive and Infant Psychology · doi:10.1080/02646838.2020.1724917 · Cited by 21
Karamoozian, M., & Askarizadeh, G. (2015) · DOAJ (DOAJ: Directory of Open Access Journals) · Cited by 20
Stress, sleep quality and unplanned C aesarean section in pregnant women
Ko, Y., Lin, P., & Chen, S. (2014) · International Journal of Nursing Practice · doi:10.1111/ijn.12267 · Cited by 20
Positive prenatal well-being: conceptualising and measuring mindfulness and gratitude in pregnancy
Matvienko‐Sikar, K., Dockray, S., & Hammond, S. (2016) · Archives of Women s Mental Health · doi:10.1007/s00737-016-0620-x · Cited by 20
Alves, A. C., Souza, R. T., Mayrink, J., Galvão, R. B., Costa, M. L., Feitosa, F. E. D. L., Filho, E. A. R., Leite, D. F. B., Tedesco, R. P., Santana, D. S., et al. (2023) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-023-05692-5 · Cited by 30
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Maternal exposure to childhood maltreatment and adverse birth outcomes
Keenan‐Devlin, L. S., Borders, A. E. B., Freedman, A. A., Miller, G. E., Grobman, W. A., Entringer, S., Simhan, H. N., Wadhwa, P. D., & Buß, C. (2023) · Scientific Reports · doi:10.1038/s41598-023-36831-9 · Cited by 18
Manifestation and Associated Factors of Pregnancy-Related Worries in Expectant Fathers
Göbel, A., Arck, P., Hecher, K., Schulte‐Markwort, M., Diemert, A., & Mudra, S. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.575845 · Cited by 18
Mood during pregnancy: Trends, structure, and invariance by gestational day
Markon, K. E., Brunette, C. A., Whitney, B. M., & O’Hara, M. W. (2021) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2021.06.006 · Cited by 17
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Maternal Influences on the Developing Fetus
DiPietro, J. A. (2010) · Springer eBooks · doi:10.1007/978-1-60327-921-5_3 · Cited by 17
Self-citationBrowne, P., Bolte, A., Claassen, E., & de Weerth, C. (2019) · Trials · doi:10.1186/s13063-019-3389-1 · Cited by 16
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Metadata
- Authors
- DiPietro, J., Ghera, M., Costigan, K., & Hawkins, M.
- Affiliations
- University of Maryland, College Park (US)
- Johns Hopkins University (US)
- Venue
- Journal of Psychosomatic Obstetrics & Gynecology
- Publisher
- Informa UK Limited
- Published
- 2004-01
- Volume
- 25
- Issue
- 3-4
- Pages
- 189-201
- ISSN
- 0167-482X (ISSN-L)
- 1743-8942
- OpenAlex
- W2123199847
- Cited by
- 198
- References
- 62
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 10 · 2023: 11 · 2022: 7 · 2021: 19 · 2020: 14 · 2019: 15 · 2018: 11 · 2017: 10 · 2016: 13 · 2015: 10 · 2014: 11 · 2013: 12 · 2012: 7
- FWCI
- 2.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychosomatic Obstetrics & Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01 HD 27592, R01HD027592)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy-related medical research
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Keywords
- pregnancy stress, daily hassles, uplift, scale reliability, scale validity, depressive symptoms, anxiety, low-risk pregnant women
- MeSH terms
- Adult, Factor Analysis, Statistical, Female, Follow-Up Studies, Humans, Pregnancy, Pregnancy Complications, Psychology, Psychometrics, Surveys and Questionnaires, Stress, Psychological, Reproducibility of Results, Cohort Studies
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