Objective: A high risk pregnancy may introduce additional psychological stress on a pregnant woman. The aim of this study was to review systematically the available evidence of the psychological consequences, in terms of anxiety and depression, of high-risk pregnancy. Methods:A systematic search of the electronic databases was performed. This review considered only quantitative, primary studies in the English language, published during the period 2000-2015 and relevant to the objective. The population of interest was previously high-risk pregnant women. Outcome variables were general anxiety, depressive symptoms and pregnancy-specific anxiety. Seven studies met the inclusion and methodological criteria and were included in the review. Results:The review revealed that high-risk pregnant women had high levels of depression ranging from 18% to 58% and these rates decrease throughout the course of hospitalization and are similar between women hospitalized in a hospital/health centre and women bed-rested in home. The review identifies additionally the main psychosocial variables that were related to antenatal anxiety and depression in high-risk pregnancy.Discussion: Future studies should overcome specific limitations.Health care professionals should enhance the implementation of psychological screening and counselling to populations of high-risk pregnant women hospitalized in a hospital/health centre or bed-rested in home.
The aim of the authors in this study was to determine the psychometric properties of the Greek adaptation of the High-Risk Pregnancy Stress Scale (HRPSS) in a sample of high-risk hospitalized pregnant women. The sample consisted of 133 high-risk pregnant women with gestational age from 9 to 37 weeks. Data were collected between February and June of 2014. HRPSS was "forward-backward" translated from English to Greek. Principal axis factoring with promax rotation was used to test the factor structure of the HRPSS. Measures of state anxiety (STAI) and depressive symptoms (EPDS) were used to assess the convergent validity of the HRPSS. Exploratory factor analysis suggested three factors: concerns of pregnancy, movement restriction, and isolation and restriction of external activities. Construct validity was confirmed by computing correlations between the HRPSS and constructions of anxiety and depressive symptoms. Internal consistency reliability was satisfactory (α = 0.813). The original factor structure of the HRPSS was only partly replicated. The results of the exploratory factor analysis suggested that a three-factor solution instead of a two-factor solution would be the most adequate. The HRPSS is an appropriate measure for assessing the levels of concerns regarding pregnancy outcome, movement restriction, isolation, and external activity restrictions in Greek high-risk pregnant women.
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