Early pregnancy dispositional optimism and pregnancy outcomes among nulliparous people

Proactive Coping in Early Pregnancy and Adverse Pregnancy Outcomes

Objective

Outside of pregnancy, proactive coping has been associated with both mental and physical well-being and with improved quality of life in chronic disease, but its effects in pregnancy are understudied. Our objective was to evaluate whether early pregnancy proactive coping was associated with adverse perinatal outcomes.

Study Design

This was a planned secondary analysis of nulliparous pregnant people recruited from a tertiary care center. Participants completed a validated assessment of proactive coping (Proactive Coping Scale) at 8-20 weeks and were followed longitudinally through delivery. Detailed pregnancy and delivery data were collected by trained research personnel. The primary outcome was a composite of adverse perinatal outcomes including unplanned cesarean delivery, gestational diabetes, and hypertensive disorders of pregnancy. Secondary analyses included individual perinatal composite components and a neonatal morbidity composite measure. Multivariate regression compared adverse perinatal outcomes by Proactive Coping Scale quartile, controlling for a priori confounders.

Results

Of the 281 parturients, the median Proactive Coping Scale score was 45.0 (range 25-55), and 47% experienced an adverse perinatal outcome. After adjusting for confounders, those in the lowest Proactive Coping Scale quartile had 2.2 times higher odds of experiencing an adverse perinatal outcome compared to those in the highest Proactive Coping Scale quartile. There were no differences in odds of the individual composite components or the adverse neonatal outcome.

Conclusion

Lower early pregnancy proactive coping scores are associated with significant increase in adverse perinatal outcomes. Interventions that target improving proactive coping may be a novel mechanism for reducing perinatal morbidity.

Impact of pregnancy/childbirth on dispositional optimism in the context of risk of depression, mental health status and satisfaction with life

Introduction

Life optimism is an inseparable element accompanying every human being. It takes different values depending on the life situation. The present study aimed to measure the level of dispositional optimism in postpartum and pregnant women, compared to women who are not pregnant and have never given birth in Poland, Greece, Turkey, Belarus, and Russia, depending on the level of life satisfaction, risk of depression and mental health.

Materials and methods

A case-control study was carried out among 2017 women, including 584 pregnant women, 528 postpartum women, and 906 women who had never been pregnant and had never given birth (control group) from Poland, Greece, Turkey, Belarus, and Russia.The study used the LOT-R Life Orientation Test, the Beck Depression Scale (BDI), the Satisfaction With Life Scale (SWLS), the GHQ- 28, and the Edinburgh Postnatal Depression Scale (EPDS) - only in the postpartum group.

Results

Women from the control group showed an average level of optimism, obtaining an average of 16 points in Belarus, 13.4 points in Poland, 13.3 points in Greece, 13.5 points in Turkey, and Russia - 16.3 points. Pregnant women from Belarus had a high level of optimism (17 points), and in other countries, an average level of optimism was in Poland - 14.5 points, Greece - 14.0 points, Turkey - 14.3 points, and Russia - 16.5 points. Women after childbirth had a high level of optimism in Belarus (17.4 points) and Russia (17.2 points), and in other countries had the average level of optimism. In these countries, the lowest level of optimism was found in non-pregnant women. No significant correlation between age and life optimism was found in any group. In Poland, life optimism increased with age in women who had never been pregnant, and in Turkey, in women who were pregnant and after childbirth.

Conclusion

Pregnant women from Belarus had a higher level of optimism than other countries. Non-pregnant women had an average level of optimism. Future studies should include larger groups of women and consider other factors that may additionally contribute to dispositional optimism.