Resilience and Stress during Pregnancy: A Comprehensive Multidimensional Approach in Maternal and Perinatal Health

Abstract

This narrative review addresses resilience and stress during pregnancy, which is part of a broader concept of maternal health. Pregnancy and postpartum are opportune periods for health promotion interventions, especially because the close contact of the women with health professionals. In this way, it can be considered a useful window of opportunity to identify women at higher risk for adverse outcomes. Integrated health is a concept that aims at providing comprehensive care related to the promotion of individuals' physical, mental, and social well-being. In this context, stress during pregnancy has been targeted as a remarkable condition to be addressed whether due to individual issues, social issues, or specific pregnancy issues, since it is directly and indirectly associated with pregnancy complications. Stress is associated with preterm birth, postpartum depression, anxiety, child neurodevelopment, and fetal distress. The way that an individual faces a stressful and adverse situation is called resilience; this reaction is individual, dynamic, and contextual, and it can affect maternal and fetal outcomes. Low resilience has been associated with poorer pregnancy outcomes. The social context of pregnancy can act as a protective or contributory (risk) factor, indicating that environments of high social vulnerability play a negative role in resilience and, consequently, in perceived stress. A given stressor can be enhanced or mitigated depending on the social context that was imposed, as well as it can be interpreted as different degrees of perceived stress and faced with a higher or lower degree of resilience. Understanding these complex mechanisms may be valuable for tackling this matter. Therefore, in the pregnancy-puerperal period, the analysis of the stress-resilience relationship is essential, especially in contexts of greater social vulnerability, and is a health-promoting factor for both the mother and baby.

Relationship between social support and parenting sense of competence in puerperal women: Multiple mediators of resilience and postpartum depression

“…Resilience is a subjective measure of the capacity to adapt to adversities in life, and encompasses concepts such as inner strength, competence, and flexibility (17). Resilience has been shown to have a protective effect on obstetric and infant outcomes (18).…”

Comunicação Na Rede De Atenção À Saúde De Gestantes/Puérperas Na Perspectiva De Trabalhadores Da Saúde

“…A gravidez é um período complexo na vida da mulher que desencadeia muitas alterações biológicas e psicológicas 20 , além de significativas adaptações endócrinas e metabólicas, que causam mudanças sistêmicas e celulares na fisiologia, o que deixa a gestante predisposta a eventos adversos 21 e complicações gestacionais 6 . Nesse contexto, ressalta-se a importância de os trabalhadores de saúde que atuam na RAS manterem uma comunicação adequada e efetiva a fim de reduzir os riscos à saúde dessas mulheres.…”

“…Por sua vez, essa é fortalecida a partir do desenvolvimento das consultas de pré-natal nas quais as mulheres são acompanhadas mensalmente. Esses momentos são transformados em oportunidades para identificar possíveis problemas decorrentes desse período 6 , bem como o histórico gestacional pregresso e possíveis agravos à saúde. A atuação compartilhada pelas equipes de saúde promove melhores desfechos no acompanhamento ao pré-natal, ao parto e ao puerpério 4 , considerando a singularidade desses períodos para a saúde das mulheres.…”

Monitoring the Dutch Solid Start Program: Developing an Indicator Set for Municipalities to Monitor their First Thousand Days-Approach

“…There is growing scientific evidence that stress during pregnancy or parenting has longand short-term consequences for children's health and development [14,29,30]. The multidimensional concept of stress [31] may require different indicators. It seems, therefore, valuable to explore which topics of the development agenda should be prioritized to be incorporated in routine registries for the purpose of local monitoring.…”