The relationship between marital adjustment and perceived prenatal stress in pregnant women

This study was conducted to determine the relationship between marital adjustment and perceived prenatal stress in pregnant women. The descriptive and correlational study was conducted between December 2022 and April 2023 with 406 healthy, spontaneous and singleton pregnant women with 36-39 weeks of pregnancy who applied to Tokat State Hospital and Tokat Gaziosmanpaşa University Hospital pregnancy outpatient clinics in Tokat city center for follow-up. "Descriptive Information Form", "Prenatal Perceived Stress Scale (PPPSS)" and "Marital Adjustment Test (MAT)" were used as data collection tools. In the analysis of the data, Student t Test was used for the comparison of two independent groups with normal distribution and One-Way Analysis of Variance (OneWay ANOVA) was used for the comparison of three or more groups. Mann-Whitney U Test was used for two-group comparisons that did not show normal distribution, and Kruskal Wallis Test was used for three or more groups. The relationship between variables was examined with Pearson Correlation Test. The mean ages of the participants were 29.73±4.46 years, 37.48±0.98 weeks of gestation, and 10.61±1.9 kilograms gained during pregnancy. It was determined that 54.5% of the women were high school graduates, 55.4% were housewives, 64% had previous pregnancies, 60.3% became pregnant voluntarily/planned, and 52.2% did not have any health problems during pregnancy. Forty-eight percent of the pregnant women received prenatal care 3 times, 33.5%2 times, 11.1% 4 times or more. The mean total and subscale mean scores of the women were as follows: PPPSS score was 3.81±0.41, medical and obstetric risks / fetal health score was 4.06±0.50, psychosocial changes during pregnancy score was 3.68±0.53, and birth expectancy score was 3.78±0.52. The women's MAT total score was 49.55±7.04. The marital adjustment scores of the participants who had high school education or higher, had no previous pregnancy, conceived voluntarily/planned, and had support for postnatal infant care were higher (p<0.05). Those whose spouses had high school education or higher and whose spouses were civil servants had higher stress levels towards psychosocial changes (p<0.05). Those who did not have a previous pregnancy and those who had health problems related to pregnancy had higher levels of stress perceived before delivery, stress levels related to psychosocial changes during pregnancy and stress levels related to expectation of delivery (p<0.05). The level of prenatal stress perceived by women who conceived voluntarily/planned pregnancy and the level of stress related to birth expectancy were lower (p<0.05). Those who never received prenatal care during pregnancy had lower levels of perceived prenatal stress and stress related to medical and obstetric risks/fetal health than those who received prenatal care (p<0.05). As the level of marital adjustment of the participants increased, the level of stress perceived prenatally, the level of stress related to medical and obstetric risks/fetal health, psychosocial changes during pregnancy and birth expectancy decreased. As the age increases, marital adjustment, perceived prenatal stress, stress level towards medical and obstetric risks/fetal health, psychosocial changes during pregnancy and stress level towards birth expectancy decrease. As the duration of marriage increases, marital adjustment, perceived prenatal stress, and stress levels related to psychosocial changes during pregnancy decrease. As the duration of pregnancy increases, the level of stress related to psychosocial changes during pregnancy decreases. However, as the weight gain during pregnancy increased, marital adjustment decreased and the level of stress related to perceived prenatal stress, psychosocial changes during pregnancy and birth expectancy increased. In conclusion, the perceived stress level of pregnant women is high. The perceived level of stress related to medical and obstetric risks / fetal health, psychosocial changes during pregnancy and expectation of childbirth is high. The majority of women have a harmonious marriage. Women with high marital harmony experience less stress during pregnancy. In prenatal care, marital adjustment should be taken into consideration along with the demographic and obstetric characteristics of the expectant mother