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Maternal Mental Health During Pregnancy and Postpartum / Menstrual Health and Disorders · Journal article
Indian Journal of Public Health · July 29, 2026
Encouraging direction, but not yet definitive.
This prospective cohort study from South India validates a novel 25-item prenatal psychosocial stress questionnaire, demonstrating that elevated stress scores (cutoff 7.5) predict adverse maternal outcomes including preeclampsia and composite adverse outcomes, and scores above 6.5 predict postpartum depression risk. The findings support stress screening in resource-limited antenatal settings but await external validation and comparison to established screening tools.
Prospective cohort study. 226 pregnant women recruited from a tertiary care hospital in South India after ethical clearance.. Intervention: Novel 25-item validated psychosocial stress questionnaire administered antepartum. n = 226. Tertiary care hospital in South India.
Elevated stress scores associated with increased preeclampsia risk (P = 0.05) Elevated stress scores associated with composite adverse maternal outcomes (P = 0.014) Elevated stress scores associated with fetal outcomes (P = 0.016)
Elevated stress scores associated with composite adverse maternal outcomes (P = 0.014) Stress score ≥7.5 identified as optimum cutoff to predict adverse outcomes
Clinicians in low–middle-income settings may consider implementing this validated stress-scoring system to identify high-risk pregnant women for early counseling and psychiatric referral to prevent adverse perinatal and postpartum outcomes. However, confirmation in other populations and healthcare settings is needed before broader adoption.
Prospective cohort study in a resource-limited setting validates a novel stress-scoring tool with statistically significant associations to adverse maternal, fetal, and postpartum outcomes, but lacks a control arm and external validation.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians in low–middle-income settings may consider implementing this validated stress-scoring system to identify high-risk pregnant women for early counseling and psychiatric referral to prevent adverse perinatal and postpartum outcomes. However, confirmation in other populations and healthcare settings is needed before broader adoption.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Abstract Background: Psychosocial stress in pregnancy can cause interference in the maternal–fetal immunological system, which can have both short- and long-term implications. The presence of a standard screening process leads to early initiation of counseling and psychiatry referral in severe conditions. Objectives: The objective of this study was to develop a specific scoring system to categorize women into different grades of psychosocial stress, thereby determining its impact on outcomes and risk of postpartum depression (PPD). Materials and Methods: This prospective cohort study was conducted in a tertiary care hospital in South India. The study recruited 226 participants after taking the institute’s ethical clearance. A novel validated questionnaire based on 25 stressors was administered antenatally, and pregnancy outcomes were documented. Receiver operating characteristic curves were used to assess the predictability of adverse maternal–fetal. P < 0.05 was considered statistically significant. Youden’s index was calibrated to identify a scoring cutoff to predict adverse outcomes. Results: A higher level of maternal education was associated with increased levels of maternal stress ( P < 0.001). Elevated stress scores were associated with increased risk of preeclampsia ( P = 0.05), composite adverse maternal outcomes ( P = 0.014), and fetal outcomes ( P = 0.016) later in pregnancy. The optimum cutoff stress score to identify risk of adverse outcomes was identified as 7.5, whereas the risk of PPD is increased with stress score levels above 6.5. A higher level of stress score was associated with increased risk of PPD ( P < 0.001). Conclusion: The novel prenatal stress scoring system is a good predictor of adverse maternal and perinatal outcomes in a low–middle-income hospital setting.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.