Awareness of maternal stress, consequences for the offspring and the need for early interventions to increase stress resilience

Anxiety, prenatal distress, and resilience during the first trimester of gestation

OBJECTIVE

To describe and analyze the relationship between pregnancy-related anxiety, prenatal distress, and individual resilience in pregnant women during the first trimester of pregnancy and compare it with the obstetric variable of parity.

METHOD

Quantitative, descriptive, cross-sectional study using non-probabilistic circumstantial sampling. A total of 144 women participated. The Prenatal Distress Questionnaire, the Resilience Scale, and the Pregnancy-Related Anxiety Questionnaire were used. A descriptive analysis with measures of central tendency was performed, and the reliability of the instruments was assessed.

RESULTS

The average age was 33.57 years. 58.3% were multiparous and 41.7% primiparous. Anxiety was found in 21.5% and very high levels of resilience in 54.9%. Primiparous women showed higher levels of worry about the future and fear of childbirth than multiparous women. Pregnant women with high resilience showed lower levels of anxiety and stress.

CONCLUSION

Pregnant women with higher levels of resilience show less anxiety and stress during the first trimester of pregnancy. Primiparous women show more anxiety and stress than multiparous women.

Developmental origins of disease highlight the immediate need for expanded access to comprehensive prenatal care

The prenatal environment plays a critical role in shaping fetal development and ultimately the long-term health of the child. Here, we present data linking prenatal health, via maternal nutrition, comorbidities in pregnancy (e.g., diabetes, hypertension), and infectious and inflammatory exposures, to lifelong health through the developmental origins of disease framework. It is well-established that poor maternal health puts a child at risk for adverse outcomes in the first 1,000 days of life, yet the full health impact of the in utero environment is not confined to this narrow window. The developmental origins of disease framework identifies cognitive, neuropsychiatric, metabolic and cardiovascular disorders, and chronic diseases in childhood and adulthood that have their genesis in prenatal life. This perspective highlights the enormous public health implications for millions of pregnancies where maternal care, and therefore maternal health and fetal health, is lacking. Despite near universal agreement that access to antenatal care is a priority to protect the health of women and children in the first 1,000 days of life, insufficient progress has been achieved. Instead, in some regions there has been a political shift toward deprioritizing maternal health, which will further negatively impact the health and safety of pregnant people and their children across the lifespan. In this article we argue that the lifelong health impact attributed to the perinatal environment justifies policies aimed at improving access to comprehensive antenatal care globally.