{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T20:42:19Z","timestamp":1789418539454,"version":"build-2803163510"},"reference-count":59,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Many studies suggest that psychological factors are intrinsically connected to the onset of preeclampsia. However, there are no relevant surveys on the psychological situation of this population. The aims of our study were to investigating the causes and prevalence of pregnancy stress in individuals at high risk of preeclampsia; exploring the correlation between pregnancy stress and anxiety, depression, and self-management capacity in this group. Our study provided evidence for the development of effective clinical management strategies and related psychological care for women at high risk of preeclampsia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross-sectional survey was conducted on women at high risk of preeclampsia who came to Jiangnan University Hospital\u2019s obstetrics outpatient clinic for antenatal care. Sociodemographic and obstetric-related characteristics, Pregnancy Stress Rating Scale (PSRS), Self-rating anxiety scale (SAS), Self-rating depression scale (SDS), Self-rating Questionnaire of Healthcare Management for Pregnancy (SQHMP) were included in this study. Data analysis covered descriptive statistics, univariate analysis, Spearman\u2019s rank correlation, and multiple linear regression analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 138 pregnant women at high risk of preeclampsia were enrolled in the study. Univariate analysis showed significant relationships between intergenerational relations (with mothers-in-law), pregnancy intention, and desired mode of delivery among pregnancy stress (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001). Median (IQR) scores were: PSRS 0.283 (0.133, 0.542), SAS 38.750 (32.500, 45.000), SDS 41.250 (33.750, 50.000), SQHMP 43.000 (35.000, 53.250). The score of Spearman\u2019s rank correlation showed that pregnancy stress was positively correlated with anxiety, depression, and self-management capacity, respectively (r\u202f=\u202f0.465, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001), (r\u202f=\u202f0.437, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001), and (r\u202f=\u202f0.585, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001). Multiple linear regression analysis showed that desired mode of delivery, anxiety, and self-management capacity were the main predictors of pregnancy stress.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The findings emphasize the need to focus on pregnancy stress in women at high risk of preeclampsia, especially those have presented higher levels of anxiety, depression, and self-management capacity. Based on these variables, healthcare professionals should increase screening for mental health in pregnant women at high risk of preeclampsia as well as provide additional psychological care.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyg.2025.1537858","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T05:24:49Z","timestamp":1747805089000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Pregnancy stress in women at high risk of preeclampsia with their anxiety, depression, self-management capacity: a cross-sectional study"],"prefix":"10.3389","volume":"16","author":[{"given":"Xing","family":"Cong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinmei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liu","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingling","family":"Cui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yurong","family":"Hua","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Gong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1111\/inr.12626","article-title":"The effects of an educational programme about preeclampsia on women's awareness: a randomised control trial","volume":"67","author":"Alnuaimi","year":"2020","journal-title":"Int. Nurs. Rev."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1007\/s11906-017-0757-7","article-title":"Pathophysiology and current clinical Management of Preeclampsia","volume":"19","author":"Amaral","year":"2017","journal-title":"Curr. Hypertens. Rep."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1186\/s12978-021-01209-5","article-title":"The relationship between social support and mental health problems during pregnancy: a systematic review and meta-analysis","volume":"18","author":"Bedaso","year":"2021","journal-title":"Reprod. Health"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1186\/s12884-019-2285-8","article-title":"Use of antidepressants and anxiolytics in early pregnancy and the risk of preeclampsia and gestational hypertension: a prospective study","volume":"19","author":"Bernard","year":"2019","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"105043","DOI":"10.1016\/j.psyneuen.2020.105043","article-title":"Maternal psychosocial functioning, obstetric health history, and newborn telomere length","volume":"123","author":"Bosquet Enlow","year":"2021","journal-title":"Psychoneuroendocrinology"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1007\/s00737-018-0834-1","article-title":"Expression of inflammatory markers in women with perinatal depressive symptoms","volume":"21","author":"Buglione-Corbett","year":"2018","journal-title":"Arch. Womens Ment. Health"},{"key":"ref7","first-page":"336","article-title":"Incidence and clinical risk factors of preeclampsia in China","volume":"28","author":"Caixia","year":"2019","journal-title":"J. Reprod. Med."},{"key":"ref8","first-page":"1353","article-title":"Progress on prenatal maternal stress among pregnant women in China","volume":"18","author":"Caiyun","year":"2020","journal-title":"Chin. J. General Prac."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1097\/jnr.0000000000000047","article-title":"Revision and validation of a scale to assess pregnancy stress","volume":"23","author":"Chen","year":"2015","journal-title":"J. Nurs. Res."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"329","DOI":"10.4040\/jkan.24008","article-title":"Moderating effect of general self-efficacy on the relationship between pregnancy stress, daily hassles stress, and preterm birth risk in women experiencing preterm labor: a cross-sectional study","volume":"54","author":"Cho","year":"2024","journal-title":"J. Korean Acad. Nurs."},{"key":"ref11","first-page":"876","article-title":"The relationship between life event and pregnancy stress: the mediating effect of mental health and the moderating effect of husband support","volume":"36","author":"Dan Li","year":"2013","journal-title":"J. Psychol. Sci."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"779","DOI":"10.1111\/cdev.13885","article-title":"Association between prenatal maternal anxiety and\/or stress and offspring's cognitive functioning: a meta-analysis","volume":"94","author":"Delagneau","year":"2023","journal-title":"Child Dev."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1038\/s41572-023-00417-6","article-title":"Pre-eclampsia","volume":"9","author":"Dimitriadis","year":"2023","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1016\/j.midw.2015.03.003","article-title":"Diet and pre-eclampsia: a prospective multicentre case-control study in Ethiopia","volume":"31","author":"Endeshaw","year":"2015","journal-title":"Midwifery"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1080\/01443615.2019.1615040","article-title":"Women's experiences of preeclampsia: a prospective survey of preeclamptic women at a single tertiary Centre","volume":"40","author":"Frawley","year":"2020","journal-title":"J. Obstet. Gynaecol."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"389","DOI":"10.21037\/cdt-22-213","article-title":"Psychosocial well-being in postpartum women with congenital heart disease","volume":"12","author":"Freiberger","year":"2022","journal-title":"Cardiovisc. Diagn. Ther."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"818","DOI":"10.3390\/ijerph20053818","article-title":"Latent trajectories and risk factors of prenatal stress, anxiety, and depression in southwestern China-a longitudinal study","volume":"20","author":"Gao","year":"2023","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1363","DOI":"10.1161\/HYPERTENSIONAHA.119.14598","article-title":"Animal models of preeclampsia causes, consequences, and interventions","volume":"75","author":"Gatford","year":"2020","journal-title":"Hypertension"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1016\/j.apnr.2014.09.002","article-title":"Relationships among psychosocial factors, biomarkers, preeclampsia, and preterm birth in African American women: a pilot","volume":"28","author":"Giurgescu","year":"2015","journal-title":"ANR."},{"key":"ref21","first-page":"21","article-title":"Mediating effect of self-efficacy on association between pregnancy pressure and antenatal depression","volume":"34","author":"Hang","year":"2017","journal-title":"Military Nursing."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1007\/s00737-015-0564-6","article-title":"The comparative effects of group prenatal care on psychosocial outcomes","volume":"19","author":"Heberlein","year":"2016","journal-title":"Arch. Womens Ment. Health"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1690","DOI":"10.1016\/j.jacc.2020.08.014","article-title":"Preeclampsia-pathophysiology and clinical presentations JACC state-of-the-art review","volume":"76","author":"Ives","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref24","first-page":"756","article-title":"Study of self-healthcare management level and influencing factors in pregnant women","volume":"45","author":"Jinzhi Li","year":"2011","journal-title":"Chin. J. Prev. Med."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1080\/03630242.2021.2014020","article-title":"Association between awareness, perceived severity, and behavioral control of COVID -19 with self-Care and anxiety in pregnancy: a cross-sectional study","volume":"62","author":"Khazaeian","year":"2022","journal-title":"Women Health"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1016\/j.preghy.2019.09.003","article-title":"Worrying yourself sick? Association between pre-eclampsia onset and health-related worry in pregnancy","volume":"18","author":"Krishnamurti","year":"2019","journal-title":"Pregn. Hypertension Int. J. Womens Cardiovascular Health."},{"key":"ref27","first-page":"487","article-title":"Depression and anxiety in early pregnancy and risk for preeclampsia","volume":"95","author":"Kurki","year":"2000","journal-title":"Obstet. Gynecol."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1161\/HYPERTENSIONAHA.111.00550","article-title":"Psychosocial stress related to the loss of a close relative the year before or during pregnancy and risk of preeclampsia","volume":"62","author":"L\u00e1szl\u00f3","year":"2013","journal-title":"Hypertension"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"12","DOI":"10.3390\/ijerph18052733","article-title":"Trajectories of depressive symptoms and anxiety during pregnancy and associations with pregnancy stress","volume":"18","author":"Lee","year":"2021","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref30","first-page":"39","article-title":"Stresses in Primiparas and their husbands during pregnancy and its related factors","volume":"24","author":"Luyan Liu","year":"2009","journal-title":"J. Nurs. Sci."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1215","DOI":"10.1089\/jwh.2010.2379","article-title":"Pregnancy intention, demographic differences, and psychosocial health","volume":"20","author":"Maxson","year":"2011","journal-title":"J. Womens Health."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"551","DOI":"10.31661\/jbpe.v0i0.2103-1294","article-title":"The design and evaluation of a Mobile based application to facilitate self-care for pregnant women with preeclampsia during COVID-19 prevalence","volume":"11","author":"Moulaei","year":"2021","journal-title":"J. Biomed. Phys. Eng."},{"key":"ref33","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1016\/j.apnr.2016.07.002","article-title":"Transition to parenthood during the transition to modernity in Jordan: new parents' views on family and healthcare support systems","volume":"32","author":"Mrayan","year":"2016","journal-title":"Appl. Nurs. Res."},{"key":"ref34","first-page":"968","article-title":"Relationship between pregnancy stress and anxiety and depression in early pregnancy","volume":"30","author":"Na","year":"2022","journal-title":"Chin. J. Clin. Psych."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"102473","DOI":"10.1016\/j.bpobgyn.2024.102473","article-title":"Preventing maternal morbidity and mortality from preeclampsia and eclampsia particularly in low- and middle-income countries","volume":"94","author":"Ngene","year":"2024","journal-title":"Best Pract. Res. Clin. Obstet. Gynaecol."},{"key":"ref36","doi-asserted-by":"publisher","first-page":"100820","DOI":"10.1016\/j.srhc.2023.100820","article-title":"Comparing prenatal and postpartum stress among women with previous adverse pregnancy outcomes and normal obstetric histories: a longitudinal cohort study","volume":"35","author":"Niela-Vilen","year":"2023","journal-title":"Sexual Rep. Healthcare Off. J.the Swedish Assoc. Midwives."},{"key":"ref37","doi-asserted-by":"publisher","first-page":"1121","DOI":"10.1002\/jcop.22527","article-title":"\"The worst time of my life\": treatment-related stress and unmet needs of women living with infertility","volume":"49","author":"\u00d6zt\u00fcrk","year":"2021","journal-title":"J. Community Psychol."},{"key":"ref38","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1038\/s41581-019-0119-6","article-title":"Pre-eclampsia: pathogenesis, novel diagnostics and therapies","volume":"15","author":"Phipps","year":"2019","journal-title":"Nat. Rev. Nephrol."},{"key":"ref39","doi-asserted-by":"publisher","first-page":"e065575","DOI":"10.1136\/bmjopen-2022-065575","article-title":"Pregnant women's attitudes to and experiences with a smartphone-based self-test for prediction of pre-eclampsia: a qualitative descriptive study","volume":"13","author":"P\u00fcschl","year":"2023","journal-title":"BMJ Open"},{"key":"ref40","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/s12884-022-04392-w","article-title":"Effects of family relationship and social support on the mental health of Chinese postpartum women","volume":"22","author":"Qi","year":"2022","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1016\/j.tjog.2020.01.002","article-title":"Factors effective in the prevention of preeclampsia:a systematic review","volume":"59","author":"Rahnemaei","year":"2020","journal-title":"Taiwan. J. Obstet. Gynecol."},{"key":"ref42","doi-asserted-by":"publisher","first-page":"E8","DOI":"10.1161\/CIRCRESAHA.118.313276","article-title":"Preeclampsia: pathophysiology, challenges, and perspectives","volume":"126","author":"Rana","year":"2020","journal-title":"Circ. Res."},{"key":"ref43","doi-asserted-by":"publisher","first-page":"1062","DOI":"10.1186\/s12889-025-22223-3","article-title":"The role of social determinants of health in woman's intention to pregnancy: a model with the mediation of social support","volume":"25","author":"Rashidi","year":"2025","journal-title":"BMC Public Health"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1016\/j.jad.2024.05.104","article-title":"The role of lack of grandparental support in perinatal depression","volume":"360","author":"Riem","year":"2024","journal-title":"J. Affect. Disord."},{"key":"ref45","doi-asserted-by":"publisher","first-page":"2128","DOI":"10.1017\/S0033291720003062","article-title":"Depressed mood and anxiety as risk factors for hypertensive disorders of pregnancy: a systematic review and meta-analysis","volume":"50","author":"Shay","year":"2020","journal-title":"Psychol. Med."},{"key":"ref46","first-page":"88","article-title":"Research on child-rearing dilemma and its influence on fertility intention in the City Group of Yangtze River Delta region","volume":"3","author":"Shuxiu","year":"2021","journal-title":"Youth Expl."},{"key":"ref47","doi-asserted-by":"publisher","first-page":"102469","DOI":"10.1016\/j.ctim.2020.102469","article-title":"The safety and effectiveness of mind body interventions for women with pregnancy induced hypertension and or preeclampsia: a systematic review and meta-analysis","volume":"52","author":"Smith","year":"2020","journal-title":"Complement. Ther. Med."},{"key":"ref48","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1016\/j.jad.2019.05.003","article-title":"Influencing factors for prenatal stress, anxiety and depression in early pregnancy among women in Chongqing, China","volume":"253","author":"Tang","year":"2019","journal-title":"J. Affect Disord."},{"key":"ref49","doi-asserted-by":"publisher","first-page":"100229","DOI":"10.1016\/j.ajogmf.2020.100229","article-title":"Effects of psychological stress on adverse pregnancy outcomes and nonpharmacologic approaches for reduction: an expert review","volume":"2","author":"Traylor","year":"2020","journal-title":"Amer. J. Obstet. Gynecol. MFM."},{"key":"ref50","first-page":"2178","article-title":"The relationship between pregnancy stress and prenatal anxiety andsocial support in pregnant women. Modern","volume":"49","author":"Tuxunnjiang","year":"2022","journal-title":"Prev. Med."},{"key":"ref51","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/j.socscimed.2019.02.027","article-title":"Coresidence with mother-in-law and maternal anemia in rural India","volume":"226","author":"Varghese","year":"2019","journal-title":"Soc. Sci. Med."},{"key":"ref52","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1111\/j.1471-0528.2008.01665.x","article-title":"Is psychosocial stress in first ongoing pregnancies associated with pre-eclampsia and gestational hypertension?","volume":"115","author":"Vollebregt","year":"2008","journal-title":"Bjog-Int. J. Obstetrics Gynaecol."},{"key":"ref53","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s12884-023-06184-2","article-title":"The mediating role of social support and resilience between self-efficacy and prenatal stress: a mediational analysis","volume":"23","author":"Wang","year":"2023","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref54","first-page":"1","article-title":"Investigation on the current status of standard pregnancy health Care and self-management behavior of rural women","volume":"22","author":"Xiao","year":"2024","journal-title":"Chin. Gen. Pract."},{"key":"ref55","first-page":"803","article-title":"Prenatal anxiety and its influence on delivery outcome","volume":"36","author":"Xihong Zhou","year":"2011","journal-title":"J. Central South Univ."},{"key":"ref56","first-page":"119","article-title":"Stress and its causes of pregnant women undergoing assisted reproductive technology","volume":"8","author":"Xuehua Cao","year":"2011","journal-title":"Clin. Med."},{"key":"ref57","first-page":"832","article-title":"Interpretation of the 2021 ISSHP clinical guidelines for disorders of hypertension in pregnancy. Journal of practical","volume":"38","author":"Yao Tang","year":"2022","journal-title":"Obstet. Gynecol."},{"key":"ref58","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1016\/j.ajog.2013.07.003","article-title":"The combined association of psychosocial stress and chronic hypertension with preeclampsia","volume":"209","author":"Yu","year":"2013","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref59","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s12884-022-05203-y","article-title":"The prevalence and associated factors of prenatal depression and anxiety in twin pregnancy: a cross-sectional study in Chongqing, China","volume":"22","author":"Zhou","year":"2022","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1016\/S0033-3182(71)71479-0","article-title":"A rating instrument for anxiety disorders","volume":"12","author":"Zung","year":"1971","journal-title":"Psychosomatics"}],"container-title":["Frontiers in Psychology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2025.1537858\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T05:24:53Z","timestamp":1747805093000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2025.1537858\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,21]]},"references-count":59,"alternative-id":["10.3389\/fpsyg.2025.1537858"],"URL":"https:\/\/doi.org\/10.3389\/fpsyg.2025.1537858","relation":{},"ISSN":["1664-1078"],"issn-type":[{"value":"1664-1078","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,21]]},"article-number":"1537858"}}