Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
Index Copernicus  – 168.52
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2018, vol. 27, nr 10, October, p. 1425–1430

doi: 10.17219/acem/73802

Publication type: original article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Evaluation of factors affecting the sense of coherence in women during pregnancy: A prospective pilot study

Monika A. Przestrzelska1,A,B,C,D,E,F, Zdzisława Knihinicka-Mercik1,A,B, Anna Gryboś1,A,B, Kuba Ptaszkowski2,C, Janusz Bartnicki1,3,E, Jerzy Zalewski1,F

1 1st Department and Clinic of Gynecology and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Poland

2 Department of Clinical Biomechanics and Physiotherapy in Motor System Disorders, Faculty of Health Sciences, Wroclaw Medical University, Poland

3 Department of Gynecology and Obstetrics, Hospital Märkisch-Oderland GmbH, Strausberg, Germany


Background. Pregnancy is a special time in the life of a woman, which induces many changes not only in the biological, but also in the biopsychosocial dimension.
Objectives. The aim of the study was to evaluate the factors affecting the sense of coherence (SOC) among women during pregnancy. It was hypothesized that a high SOC will depend on a high level of received support, lack of the risk of mental disorders in the perinatal period and physiological course of pregnancy.
Material and Methods. Factographic material was collected by a diagnostic survey method. As a 1st research tool, the Polish adaptation of the Sense of Coherence – Orientation to Life Questionnaire (SOC-29) was used. Another research tool was the Edinburgh Postnatal Depression Scale (EPDS), used here for pregnant women and therefore called Edinburgh Depression Scale (EDS).
Results. We analyzed the data of all 200 women with physiological pregnancies and 200 women with complicated pregnancies from whom a complete valid responses were obtained. All women were aged between 18 and 36 years. Significant predictors of low SOC results in the model were: age (odd ratio [OR] = 0.929, 95% confidence interval [CI] 0.870–0.992, p = 0.0280), being multipara (OR = 1.996, 95% CI 1.271–3.135, p = 0.0027), having never/occasionally husband/partner support (OR = 1.978, 95% CI 1.070–3.656, p = 0.0295), and EDS results (OR = 1.312, 95% CI 1.169–1.472, p = 0.0000).
Conclusion. Predisposing factors for the occurrence of a low rate of SOC in pregnant women are: lower age, multiparity, lack of social support, especially from the husband/partner, and the risk of depression during pregnancy. This may result from the fact that a strong SOC develops in the process of socialization, and with age we acquire the ability to accurately assess reality.

Key words

depression, pregnancy, coherence, social support

References (40)

  1. Beck CT. A meta-analysis of predictors of postpartum depression. Nurs Res. 1996;45(5):297–303.
  2. Kossakowska K. Prevention of postpartum depression – the role of health professionals in identifying risk factors and symptoms of the disease [in Polish]. Medycyna Ogólna i Nauki o Zdrowiu. 2013;19(4):463–468.
  3. Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987;150:782–786.
  4. Borysewicz K. The Edinburgh Postnatal Depression Scale [in Polish]. Postepy Psychiatr Neurol. 2000;9:71–77.
  5. Antonovsky, A. Health, Stress and Coping. San Francisco, CA: Jossey-Bass; 1997.
  6. Antonovsky A. Unraveling the Mystery of Health: How People Manage Stress and Stay Well. 1st ed. San Francisco, CA: Jossey-Bass; 1987:34–45.
  7. Eriksson M, Lindström B. Antonovsky’s sense of coherence scale and the relation with health: A systematic review. J Epidemiol Community Health. 2006;60(5):376–381.
  8. Glazier RH, Elgar FJ, Goel V, Holzapfel S. Stress, social support, and emotional distress in a community sample of pregnant women. J Psychosom Obstet Gynaecol. 2004;25(3–4):247–255.
  9. Maçola L, do Vale IN, Carmona EV. Assessment of self-esteem in pregnant women using Rosenberg’s Self-Esteem Scale [in Portuguese]. Rev Esc Enferm USP. 2010;44(3):570–577.
  10. Bielawska-Batorowicz E. High risk pregnancy. In: Psychological Aspects of Procreation. Katowice, Poland: Wydawnictwo Naukowe “Śląsk”; 2006:153–182.
  11. Holmes TH, Rahe RH. The social readjustment rating scale. J Psychosom Res. 1967;11(2):213.
  12. Rymaszewska J, Dolna M, Gryboś M, Kiejna A. Mental disorders during pregnancy and postpartum period: Epidemiology, etiology, classification and treatment [in Polish]. Ginekol Pol. 2005;74(4):321–330.
  13. Dietz P, Williams SB, Callaghan WM, Bachman DJ, Whitlock EP, Hornbrook MC. Clinically identified maternal depression before, during, and after pregnancies ending in live births. Am J Psychiatry. 2017;164(10):1515–1520.
  14. Cox JL, Murray D, Chapman G. A controlled study of the onset, duration and prevalence of postnatal depression. Br J Psychiatry. 1993;163:27–31.
  15. Gavin NI, Gaynes BN, Lohr KN, Meltzer-Brody S, Gartlehner G, Swinson T. Perinatal depression: A systematic review of prevalence and incidence. Obstet Gynecol. 2005;106(5 Pt 1):1071–1083.
  16. Robertson E, Grace S, Wallington T, Stewart DE. Antenatal risk factors for postpartum depression: A synthesis of recent literature. Gen Hosp Psychiatry. 2004;26(4):289–295.
  17. Kettunen P, Koistinen E, Hintikka J. Is postpartum depression a homogenous disorder: Time of onset, severity, symptoms and hopelessness in relation to the course of depression. BMC Pregnancy Childbirth. 2014;14:402.
  18. Tharner A, Luijk MP, van Ijzendoorn MH, et al. Maternal lifetime history of depression and depressive symptoms in the prenatal and early postnatal period do not predict infant-mother attachment quality in a large, population-based Dutch cohort study. Attach Hum Dev. 2012;14(1):63–81.
  19. Pinto TM, Caldas F, Nogueira-Silva C, Figueiredo B. Maternal depression and anxiety and fetal-neonatal growth. J Pediatr (Rio J). 2017;93(5):452–459.
  20. McFarland J, Salisbury AL, Battle CL, Hawes K, Halloran K, Lester BM. Major depressive disorder during pregnancy and emotional attachment to the fetus. Arch Womens Ment Health. 2011;14(5):425–34.
  21. Li Y, Long Z, Cao D, Cao F. Social support and depression across the perinatal period: A longitudinal study. J Clin Nurs. 2017;26(17–18):
  22. Kinsella MT, Monk C. Impact of maternal stress, depression & anxiety on fetal neurobehavioral development. Clin Obstet Gynecol. 2009;52(3):425–440.
  23. Beck CT. Predictors of postpartum depression: An update. Nurs Res. 2001;50(5):275–285.
  24. Silverman ME, Reichenberg A, Savitz DA, et al. The risk factors for postpartum depression: A population-based study. Depress Anxiety. 2017;34(2):178–187.
  25. O’Hara MW, Swain AM. Rates and risk of postpartum depression and meta-analysis. Int Rev Psychiatry. 1996;8(1):37–54.
  26. Lewicka M, Wdowiak A, Sulima M, Wójcik M, Makara-Studzińska M. Evaluation of negative emotions using the DASS scale in a group of pregnant women hospitalized in the department of pregnancy pathology [in Polish]. Problemy Higieny i Epidemiologii. 2013;94(3):
  27. Sjöström H, Langius-Eklöf A, Hjertberg R. Well-being and sense of coherence during pregnancy. Acta Obstet Gynecol Scand. 2004;83(12):1112–1118.
  28. Pięta B, Jurczyk MU, Wszołek K, Opala T. Emotional changes occurring in women in pregnancy, parturition and lying-in period according to factors exerting an effect on a woman during the peripartum period. Ann Agric Environ Med. 2014;21(3):661–665.
  29. Dibaba Y, Fantahun M, Hindin MJ. The association of unwanted pregnancy and social support with depressive symptoms in pregnancy: Evidence from rural southwestern Ethiopia. BMC Pregnancy Childbirth. 2013;13:135.
  30. Lancaster CA, Gold KJ, Flynn HA, Yoo H, Marcus SM, Davis MM. Risk factors for depressive symptoms during pregnancy: A systematic review. Am J Obstet Gynecol. 2010;202(1):5–14.
  31. Gipson JD, Koenig MA, Hindin MJ. The effects of unintended pregnancy on infant, child, and parental health: A review of the literature. Stud Fam Plann. 2008;39(1):18–38.
  32. Morikawa M, Okada T, Ando M, et al. Relationship between social support during pregnancy and postpartum depressive state: A prospective cohort study. Sci Rep. 2015;5:10520.
  33. Logsdon MC, Cognac-Griffin D. Social support in the postpartum adolescents: Guidelines for nursing assessments and interventions. J Obstet Gynecol Neonatal Nurs. 2005;34(6):761–768.
  34. Dennis CL, Ross L. Women’s perceptions of partner support and conflict in the development of postpartum depressive symptoms. J Adv Nurs. 2006;56(6):588–599.
  35. Husain N, Cruickshank K, Husain M, Khan S, Tomenson B, Rahman A. Social stress and depression during pregnancy and in the postnatal period in British Pakistani mothers: A cohort study. J Affect Disord. 2012;140(3):268–276.
  36. Ludermir AB, Lewis G, Valongueiro SA, de Araújo TV, Araya R. Violence against women by their intimate partner during pregnancy and postnatal depression: A prospective cohort study. Lancet. 2010;376(9744):903–910.
  37. Satoh A, Kitamiya C, Kudoh H, Watanabe M, Menzawa K, Sasaki H. Factors associated with late post-partum depression in Japan. Jpn J Nurs Sci. 2009;6(1):27–36.
  38. Segre LS, O’Hara MW, Arndt S, Stuart S. The prevalence of postpartum depression: The relative significance of three indices of social status. Soc Psychiatry Psychiatr Epidemiol. 2007;42(4):316–321.
  39. Mayberry LJ, Horowitz ME, Declercq E. Depression symptom prevalence and demographic risk factors among US women during the first 2 years postpartum. J Obstet Gynecol Neonatal Nurs. 2007;36(6):542–549.
  40. Jin P, Mori E, Sakajo A. Risk factors, cross-cultural stressors and postpartum depression among immigrant Chinese women in Japan. Int J Nurs Pract. 2016;22(Suppl 1):38–47.