Rlationship Between Life Events,Psychological Resilience And Pregnancy Outcomes In Late Pregnancy

ObjectiveTo describe the current state of psychological resilience in late pregnancy;To explore the influence of maternal life events and psychological resilience on pregnancy outcomes.MethodsUsing convenience sampling method,pregnant women awaiting delivery in hospital who met the inclusion criteria in a 3A-grade hospital in Shandong Province were selected from March to July 2020.To evaluate the general information,maternal life events,psychological resilience and pregnancy outcomes,self-administered questionnaires on the general information,the maternal life events scale,the psychological resilience scale,the psychological stress scale,and the pregnancy outcome information were used.And data management and analysis were performed using SPSS 22.0.The main statistical methods include descriptive statistical analysis,Chi-square test,independent sample T-test,analysis of variance,Pearson correlation analysis,Logistic regression analysis,stratified regression analysis,etc.Results（1）Current state of maternal psychological resilience in late pregnancyThe average age of the 862 pregnant women in this study was（31.81±5.28）years,while the three psychological resilience dimensions were scored as tenacity（31.52±9.08）,strength（22.09±5.35）and optimism（10.34±2.70）,with a total score of（63.95±15.87）.（2）The relationship between psychological resilience,life events and maternal outcomes in late pregnancyPsychological stress level score of pregnant women was（15.64±5.58）.The scores of maternal life events,subjective events（SE）and objective events（OE）were respectively（165.39±159.84）,（46.01±57.78）,（56.56±66.26）in OE1（positive objective events）,（30.26±55.04）in OE2（negative objective events）,as well as（32.56±45.88）in OE3（negative objective events in social relations）Correlation analysis showed that psychological resilience was significantly negatively correlated with psychological stress level（r=-0.412,P<0.01）and maternal life events（r=-0.085,P<0.05）in late pregnancy,and that there was a significant positive correlation between psychological stress level and maternal life events（r=0.213,P<0.01）.Stratified regression showed that,with psychological stress level as the dependent variable and controlling for confounding variables（maternal age,residence,pre-pregnancy BMI and education）,SE（β=0.253,P<0.001）and OE3（β=0.140,P<0.001）could positively predict psychological stress level,OE1（β=-0.157,P<0.001）could negatively predict psychological stress,while OE2 was not significantly related to psychological stress levels.Besides,the strength dimension of psychological resilience（β=-0.263,P<0.001）negatively predicted maternal psychological stress levels,whereas the resilience and optimism dimensions did not predict maternal stress levels.With maternal pregnancy complications/comorbidities as the dependent variables,the dimensions of life events could not predict the occurrence of pregnancy complications/comorbidities.The psychological resilience strength（OR=0.936,95%CI=0.891～0.984）was a protective factor for the occurrence of pregnancy complications/comorbidities,while psychological resilience tenacity and optimism could not predict the occurrence of pregnancy complications/comorbidities.（3）The relationship between psychological resilience,life events and neonatal outcomes in late pregnancyWith neonatal outcomes as the dependent variable,control for demographic and sociological variables（maternal age,residence,pre-pregnancy BMI）as model one,four dimensions of life events were added to model two,and dimensions of psychological resilience were further added to model three for a stratified regression analysis.The results showed that OE1（β=0.092,P=0.010）could positively predict the gestational weeks of newborn with gestational weeks as a dependent variable.Strength dimension of psychological resilience（β=0.147,P=0.019）could positively predict the gestational weeks of newborns,while optimism dimension（β=-0.121,P=0.019）could negatively predict the gestational weeks,but tenacity could not.While OE1（β=0.090,p=0.014）could positively predict birth weight of newborn with birth weight as a dependent variable.Strength dimension of psychological resilience（β=0.150,p=0.018）could positively predict birth weight,while tenacity and optimism could not.While OE2 was a risk factor（OR=1.005,95%CI=1.000 to 1.010）,OE1 was a protective factor（OR=0.994,95%CI=0.989～0.998）,whereas life events SE and OE3 could not predict the occurrence of neonatal complications with neonatal complications（neonatal pneumonia and neonatal respiratory distress syndrome）as dependent variables.Strength dimension of psychological resilience（OR=0.899,95%CI=0.826～0.979）was a protective factor,whereas tenacity and optimism could not predict the occurrence of neonatal complications.While strength dimension of psychological resilience（OR=0.804,95%CI=0.657～0.984）significantly negatively influenced neonatal 1-minute Apgar score and was a protective factor with 1-minute Apgar score as a dependent variable.In comparison,optimism dimension（OR=1.438,95%CI=1.017～2.033）significantly positively influenced the neonatal 1-minute Apgar score and was a risk factor.However,tenacity dimension could not predict neonatal 1-minute Apgar score.Conclusion（1）The maternal psychological resilience in late pregnancy was at a moderate level.（2）Maternal life events and psychological resilience were significant predictors of pregnancy outcomes,with subjective life events,negative objective events in social relationships significantly and positively predicting maternal stress levels,while positive objective events and strength dimensions of psychological resilience significantly and negatively predicting psychological stress levels.In addition,the strength dimension of psychological resilience was a protective factor for the occurrence of pregnancy complications/comorbidities.（3）Maternal life events and psychological resilience were significant predictors of neonatal outcomes,with positive objective life events and the strength dimension of psychological resilience significantly and positively predicting gestational weeks and weight of newborn,and negatively predicting the risk of neonatal complications.