Influence of psychosocial problems on healthy lifestyle among pregnant women

DISCUSSION

In this study, different ratios for the ageing of pregnant women were relied upon to determine through these ratios in any age group are applied good nutrition and a good lifestyle for pregnant women.

The current study concentrates on Psychosocial variables because its represents the most important types of problems experienced by pregnant women. Hormones in pregnancy affect the pregnancy's psychological state, performing many mood swings, with the couple at this stage facing fears of responsibility and new role .These changes occur during different stages of pregnancy and are normal in comparison with the significant change in life resulting from pregnancy.

The result of current study agree with several studies, Woods et al., 2010, showed that The majority of participants reported antenatal psychosocial stress (78% low-moderate, 6% high), Antenatal psychosocial stress was widespread in a cohort of culturally and economically varied pregnant women attending a university-based prenatal clinic, with slightly higher mean levels earlier in pregnancy. Depression, panic disorder, drug usage, domestic violence, and having more than two medical comorbidities were all linked to high levels of prenatal psychosocial stress (Woods et al.,2010). Also changes in nutrition, sleep, fitness, substance usage, tobacco use, and/or utilization of prenatal care are all examples of behavioural responses to stress. Neuroendocrine and immunological responses are possible physiologic responses to psychological stress (Hobel and Culhane,2003). The different demography of the sample regarding to Age Groups in order to know the determination in which age group psychological problems increase and which age group prefers to apply lifestyle. The result of current study agree with Nakazibwe, that showed in his thesis age did not have influence on pregnant woman’s involvement in physical exercise (Nakazibwe, 2016). The no significance in residency, education, may be due to small size of sample, or due to less variation in Socio-demographic Characteristics espial in residency character and education level. Women's education with their husbands was more successful than women's education alone. This study also found that education had a positive impact on sadness and anxiety (Sanaati et al., 2017). As higher education has also been shown to protect against the development of prenatal depression; so, the high education in this thesis may indicate why the incidence of depression is lower than what is observed in the general population (Jahan et al., 2021).

As no significant differences between psychosocial problems and lifestyle with regard to women and husband’s occupation of pregnant women, except there is significant relationship between depression and husband’s occupation, while there were significant differences between lifestyle and monthly, but there is no significant relationship among depression, anxiety, and social problems. This result may be because the income of pregnant women helps in make fair lifestyle, fair lifestyle necessary to decrease pregnancy complications. there are high significant differences between anxiety and number of gravida and parity while no significant differences have been reported among depression, social problems and lifestyle. 

Hou et al., revealed that having babies at home can reduce maternal women's stress levels, with no difference between having one baby and having two babies (Hou et al.,2018). The first reason is that first-time moms were extremely concerned about their newborns' safety and well-being, and were well aware that they were responsible for another life after delivery. Pregnant women who did not have a baby at home, on the other hand, were concerned about the new baby's care after birth because they lacked confidence in themselves as new mothers to care for their child. In fact, prior to becoming a mother, most women have very few opportunities to interact with kids and learn from others. Finally, having a child at home may improve the family's happiness.

One of the most important techniques for ensuring a healthy pregnancy is antenatal care. Despite their poverty, most women in the current study received irregular prenatal care, and the main reason for this positive development is the proximity of a public sector hospital that provides free health services.

there is correlation between depression and stillbirth at p-value= .013. While between anxiety, social problems and lifestyle there is no relationship. This result occurs because mothers, who have suffered from the loss of their fetus, especially during their first pregnancy, will suffer from depression as well as affecting some health aspects. The most important of these are: severe anxiety about the loss of the next pregnancy, especially when it occurs with an approaching period of first pregnancy and severe self-blame for not being able to keep the pregnancy, but not necessarily because of the mother's neglect. Keramat et al., found the existence of problems in past pregnancies (for whatever reason) was linked to stress during the present pregnancy, according to this study (Keramat et al.,2021).

This is true also for number of previous abortions, the loss of baby during pregnancy leads to fear, stress and anxiety that abortion will occur again in the next pregnancy. It is crucial to evaluate women's behaviours that may relate to the experience of depressed symptoms while looking into the predictive nature of a large number of pregnancies on depression. Klutsey and Ankomah (2014) showed that women with second pregnancies had an increased chance of induced abortions, while women with more than two pregnancies had approximately a 6-fold rate of induced abortions, in a research in Ghana's Volta area (Klutsey & Ankomah, 2014). Other study agrees with current results, Silva et al., found the presence of complications in previous pregnancies and the history of abortion/risk of preterm birth were also shown to be risk factors for anxiety during the prenatal period (Silva et al.,2017).

The Psychosocial problems increase in state of little time between pregnancies, the pregnancy interval at least two years between pregnancies must be for a woman to regain her post-natal status in terms of her weight, hormones and changes during pregnancy. So, the best solution to reduce mental problems depending on the period between pregnancies is the planned pregnancy. Gebremedhin et al., demonstrated a summary of the most recent information on the impact of the interpregnancy interval on pregnancy problems (Gebremedhin et al.,2018). The duration between birth and the start of the next pregnancy (interpregnancy interval (IPI)) has been associated to a higher risk of unfavorable outcomes in both infants and mothers (Shachar and Lyell,2012).

In this study the prevalence of depression due to several reasons such as low level of education, pregnant women not have enough social support from her husband or her family. Depression leads to a state of sadness and crying without reason and thinking very sadly about the direction of simplest things. That's why this condition needs to be addressed because it negatively affects the mother and the fetus. In local study in Erbil, Mishkin et al., 2021 showed in Iraq, the first time that pregnant women seeking maternal health services have been diagnosed with prenatal depression. The 179 participants, 86 (48%) reported depressive symptoms. In Erbil, Iraq, a significant number of women suffer from prenatal depression. Pregnant women between the ages of 25 and 29 had a lower risk of depression than younger women, in contrast to a meta-analysis in Ethiopia that showed that pregnant women between the ages of 20 and 29 were more likely to show signs of prenatal depression (Ayano et al.,2019). Probably due to the cultural and educational disparities between the two countries. Because the majority of pregnant women in this age group had previous work experience, they were less concerned about finding work after getting pregnant.

This result due to hormonal changes occurs through pregnancy especially if the pregnancy happens by twin, because the twin needs more responsibility. the pregnant woman suffers from anxiety about eating, drinking and thoughts about fetal health. The neurohormonal substances responsible for stress are also important for anxiety in human physiology, according to this study, which could explain the common comorbidity between stress and anxiety.

This study showed that 60% of pregnant women are having moderate level of social problems. This result explains, the presence of social problems due to multiple factors such as economic problems, absence of support, mental disorders. The result of current study agrees with Suzuki, and Eto, showed that Year after year, the number of pregnant women with socioeconomic issues grew (p 0.01) (Suzuki, and Eto,2020). The distribution of high-risk factors linked to social problems has stayed nearly unchanged. During the early stages of pregnancy, it is critical to identify the life environment and acceptance condition for pregnancy, as well as give support to fill in the gaps.Other study demonstrated by Yu et al., showed pregnant women having a moderate relationship with their mother-in-law were more than twice as likely as those with an excellent relationship to experience prenatal depression symptoms (Yu et al., 2020). Absence of social support was found to be a risk factor for depressive symptoms, and pregnant women had control over their depression. Social support function was a social determinant of mental health for pregnant women because it was an essential social resource. Positive social support helped people feel cared for, cherished, and appreciated, which could enhance and mental health of pregnant women (Thompson et al.,2017).

This study shows high awareness that fair lifestyle lead to make pregnancy period with less risk of pregnancy. Lifestyle must be balanced for pregnant women so you must follow a balanced health system and exercise the right sport for the period of pregnancy. Claesson et al., showed this assertion is also true for obese pregnant women who are physically active. A woman suffering from depression symptoms may struggle to find motivation to begin or sustain physical activity (Claesson et al.,2014)

Asignificant effect between social problems and lifestyle among pregnant women as reported while psychological problems related to depression and anxiety shows no effect on lifestyle. Omidvar et al., 2018, showed in all domains of healthy lifestyles in pregnant women, state anxiety and trait anxiety were the most unfavorable independent variables, according to the findings, Also depression symptoms were found to be negatively associated with nutrition, stress management, physical exercise, health responsibility, and self-actualization (Omidvar et al., 2018).

The current study shows positive correlation between social problem and lifestyle which this explains the absence of social support will cause decreasing of lifestyle of pregnant women. Faramarzi and Pasha, showed certain unfavorable social contacts may be harmful to one's health, most studies have stressed the benefits of social support. The largest negative predictor of stress during pregnancy was family support, followed by support from friends and neighbors and perception of support. Furthermore, using a variety of communication strategies, such as individual or group therapy, and providing the required training for pregnant women and those who care for them, particularly their husbands may be beneficial in prenatal care (Faramarzi and Pasha, 2015).

CONCLUSIONS

Psychosocial problems including (depression and anxiety) can affected pregnant women in different ages, residency, education, occupation, and have negative imapact on the lifestyle of pregnant women. The preconception period should be targeted to optimize modifiable lifestyle behaviours.

REFERENCES

Hashim, M., Coussa, A., Al Dhaheri, A., Al Marzouqi, A., Cheaib, S., et al., 2021. Impact of coronavirus 2019 on mental health and lifestyle adaptations of pregnant women in the United Arab Emirates: a cross-sectional study. BMC Pregnancy and Childbirth, 21(515), pp, 1-11.

Bedaso, A., Adams, J., Peng, W. & Sibbritt, D., 2021. The relationship between social support and mental health problems during pregnancy: a systematic review and meta-analysis. Reprod Health, 18(162), pp, 1-23. 

Zinsser, L. A., Stoll, K., Wieber, F., Pehlke-Milde, J., & Gross, M. M. 2020. Changing behaviour in pregnant women: A scoping review. Midwifery, 85, 102680.

Woods, S.M., Melville, J.L., & Gavin, A., Y., 2010. Psychosocial stress during pregnancy. Am J Obstet Gynecol, 202(61), pp, 61-67.

Hobel, C., & Culhane, J., 2003. Role of psychosocial and nutritional stress on poor pregnancy outcome. J Nutr, 133, pp,1709-1717.

Nakazibwe W. Exploring the psychological factors affecting the participation of pregnant women in physical activities in uganda. Master’s Thesis in Sport and Exercise Psychology Spring 2016 Department of Sport Sciences University of Jyvaskyla.

Sanaati, F., Mohammad-Alizadeh Charandabi, S., Farrokh Eslamlo, H., Mirghafourvand, M., & Alizadeh Sharajabad, F. (2017). The effect of lifestyle-based education to women and their husbands on the anxiety and depression during pregnancy: a randomized controlled trial. The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 30(7), pp. 870–876.

Jahan, N., Went, T., & Alfanso, M., 2021. Untreated Depression During Pregnancy and Its Effect on Pregnancy Outcomes: A Systematic Review. Currens, 13(8), pp, 1-22.

Hou, Q., Li, S., Jiang, C.,  Huang, Y., Huang, L., et al., 2018. The associations between maternal lifestyles and antenatal stress and anxiety in Chinese pregnant women: A cross-sectional study. Sci Rep 8, 10771.

Keramat, A., Malary, M., Moosazadeh, M., Bagherian, N., & Rajabi-Shakib, M., 2021. Factors influencing stress, anxiety, and depression among Iranian pregnant women: the role of sexual distress and genital self-image. BMC Pregnancy Childbirth 21, 87.

Klutsey, E. E., & Ankomah, A. (2014). Factors associated with induced abortion at selected hospitals in the Volta Region, Ghana. International journal of women's health, 6, 809.

Faramarzi, M., & Pasha, H., 2015. The Role of Social Support in Prediction of Stress During Pregnancy. J Babol Univ Med Sci.,17(11), pp, 52 -60.

Silva, M., Nogueira, D., Clapis, M. &, Leite E., 2017. Anxiety in pregnancy: prevalence and associated factors. Rev Esc Enferm USP., 51,03253.

Omidvar, S., Faramarzi, M., Hajian-Tilak, K., Nasiri, F., 2018. Associations of psychosocial factors with pregnancy healthy life styles. PLoS ONE, 13(1), e0191723.

Claesson, I. M., Klein, S., Sydsjö, G., & Josefsson, A. (2014). Physical activity and psychological well-being in obese pregnant and postpartum women attending a weight-gain restriction programme. Midwifery, 30(1), 11–16.

Gebremedhin, A. T., Regan, A. K., Malacova, E., Marinovich, M. L., Ball, S., Foo, D., & Pereira, G. (2018). Effects of interpregnancy interval on pregnancy complications: protocol for systematic review and meta-analysis. BMJ open, 8(8), e025008.

Shachar, B., & Lyell, D., 2012. Interpregnancy interval and obstetrical complications. Obstet Gynecol Surv, 67, pp,584–96.

Mishkin, K., Maqsood, S. S., & Ahmed, H. M. (2021). Antenatal Depression Symptoms Among Pregnant Women Seeking Health Services in Erbil, Iraq. Maternal and child health journal, 25(7), 1043–1049.

Ayano, G., Tesfaw, G., & Shumet, S., 2019. Prevalence and determinants of antenatal depression in Ethiopia: a systematic review and metaanalysis. PLoS, 14,e0211764.

Suzuki S., & Eto, M., 2020. Current Status of Social Problems during Pregnancy at a Perinatal Center in Japan. JMA J., 3(4), 307-312.

Yu, Y., Zhu, X., Xu, H., Hu, Z., Zhou, W., Zheng, B., & Yin, S. (2020). Prevalence of depression symptoms and its influencing factors among pregnant women in late pregnancy in urban areas of Hengyang City, Hunan Province, China: a cross-sectional study. BMJ open, 10(9), e038511.

Thompson, T., Pérez, M., Kreuter, M., Margenthaler, J., Colditz, G., & Jeffe, D. B. (2017). Perceived social support in African American breast cancer patients: Predictors and effects. Social science & medicine (1982), 192, 134–142.