{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T14:36:34Z","timestamp":1773930994528,"version":"3.50.1"},"reference-count":25,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:00:00Z","timestamp":1773792000000},"content-version":"unspecified","delay-in-days":17,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"2025 Government funded Clinical Medical Excellence Talent Development Programme","award":["ZF2025008"],"award-info":[{"award-number":["ZF2025008"]}]},{"name":"Medical Science Research Project of Hebei Province","award":["20230005"],"award-info":[{"award-number":["20230005"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,1,21]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Pregnancy constitutes a pivotal developmental transition for primigravidas. Although inadequate maternal role adaptation is a recognised predictor of antenatal distress, most existing studies have employed cross-sectional designs or concentrated primarily on the postpartum period. Little is known about the dynamic, longitudinal patterns of role adaptation during pregnancy or how these trajectories shape stage-specific psychological challenges. This study seeks to identify latent heterogeneous trajectories of maternal role adaptation among primigravidas and to evaluate their associations with stage-specific psychological outcomes, including pregnancy-related stress, body image disturbance and fear of childbirth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This multicentre, prospective, longitudinal observational cohort study will enrol 240 primigravidas with a gestational age of 14 weeks or less from six tertiary hospitals in Shijiazhuang, China. Data will be collected at three clinically important time points, T0 (12\u201314 weeks), T1 (26\u201328 weeks) and T2 (35\u201337 weeks). Latent class growth analysis will be used to identify distinct trajectory subgroups of maternal role adaptation. The associations between these trajectory classes and stage-specific psychological outcomes, including pregnancy stress at T0, body image disturbance at T1 and fear of childbirth at T2, will be examined using the Bolck-Croon-Hagenaars method with demographic covariates controlled. Missing data will be managed using full information maximum likelihood estimation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval has been granted by the Ethics Committee of Hebei Provincial People\u2019s Hospital (approval number 2025586). Written informed consent will be obtained from all participants. The study findings will be disseminated through publication in peer-reviewed journals, presentations at international academic conferences and summary reports shared with the participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>ChiCTR2500114060.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-115492","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T11:50:22Z","timestamp":1773921022000},"page":"e115492","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Latent trajectories of role adaptation in first-time pregnant women and their associations with pregnancy-specific psychological disorders: a longitudinal research protocol"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2845-6300","authenticated-orcid":false,"given":"Huiya","family":"Ma","sequence":"first","affiliation":[{"name":"School of Nursing, Hebei Medical University, Shijiazhuang, Hebei, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0205-1656","authenticated-orcid":false,"given":"Lan","family":"Ge","sequence":"additional","affiliation":[{"name":"Department of Nursing, Hebei General Hospital, Shijiazhuang, Hebei, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1765-082X","authenticated-orcid":false,"given":"Xinling","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Nursing, Hebei General Hospital, Shijiazhuang, Hebei, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"key":"2026031904501066000_16.3.e115492.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1547-5069.2004.04042.x"},{"key":"2026031904501066000_16.3.e115492.2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2648.2004.02991.x"},{"key":"2026031904501066000_16.3.e115492.3","doi-asserted-by":"publisher","DOI":"10.1097\/00012272-200009000-00006"},{"key":"2026031904501066000_16.3.e115492.4","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1007\/s00737-014-0424-9","article-title":"The relationship between maternal attitudes and symptoms of depression and anxiety among pregnant and postpartum first-time mothers","volume":"17","author":"Sockol","year":"2014","journal-title":"Arch Womens Ment Health"},{"key":"2026031904501066000_16.3.e115492.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2008.07.006"},{"key":"2026031904501066000_16.3.e115492.6","doi-asserted-by":"publisher","DOI":"10.1097\/YCO.0b013e3283503680"},{"key":"2026031904501066000_16.3.e115492.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.bodyim.2005.09.002"},{"key":"2026031904501066000_16.3.e115492.8","doi-asserted-by":"crossref","DOI":"10.1186\/s12905-025-03717-z","article-title":"Developmental trajectories of maternal fear of childbirth at different times: a prospective longitudinal study","volume":"25","author":"Jing","year":"2025","journal-title":"BMC Womens Health"},{"key":"2026031904501066000_16.3.e115492.9","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1111\/j.1751-9004.2007.00054.x","article-title":"An Introduction to Latent Class Growth Analysis and Growth Mixture Modeling","volume":"2","author":"Jung","year":"2008","journal-title":"Social & Personality Psych"},{"key":"2026031904501066000_16.3.e115492.10","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"2026031904501066000_16.3.e115492.11","unstructured":"National Health and Family Planning Commission of the People\u2019s Republic of China . 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