Psychosocial Stress during Pregnancy and its Relation to Fetal Outcome: A Study from Patan Hospital, Lalitpur, Nepal

Abstract

Introduction: Psychosocial stress during pregnancy influences birth-weight, gestational age and intrauterine growth. However, it is not known how stress influences pregnancy in Nepalese women.

Methodology: We conducted a cross-sectional prospective observational study among the pregnant women attending Antenatal Checkup (ANC) at the ANC of Patan Hospital using self-administered questionnaire. Stress was measured by 12-item General Health Questionnaire (GHQ-12) and stressful life events by 21 item modified life events inventory. Sample size was 226. Women who delivered at Maternity ward of the hospital after 28 weeks of gestation, irrespective of the outcome were eligible for analysis.

Results: Low Birth Weight (LBW), prematurity and Intrauterine Growth Restriction (IUGR) were 13(5.8%), 28(13%) and 10(4.4%) respectively. LBW, prematurity and IUGR among the stressed women were 15.9%, 7.5% and 7.5% compared to 10.8%, 4.9% and 2.7% respectively among the non-stressed women. Women with >2 stressful life events were likely to have prematurity (p=0.017) and IUGR (p=0.017). These babies were prone for fetal complications. Women with growth restricted fetus had higher maternal complications (p=0.03).

Conclusion: Stress during pregnancy was associated with prematurity and IUGR. These babies were more prone for fetal and maternal complications. Stressful life events affected adverse pregnancy outcome.