Psychometric validation of the Chinese version of the perceived stress scale-10 among pregnant women

Stress during pregnancy can significantly impact maternal and fetal health. Accurately assessing perceived stress is crucial for early intervention and improved health outcomes. The Perceived Stress Scale (PSS-10) is a widely used tool for measuring perceived stress. However, the Chinese version (CPSS-10) has not yet been validated among pregnant women in mainland China. This study aimed to evaluate the psychometric properties of the CPSS-10 in this population. The study was conducted in a Chinese hospital between February and August 2024, using a convenience sample of pregnant women. The CPSS-10 was evaluated using exploratory (EFA) and confirmatory (CFA) factor analyses. EFA employed principal component analysis and varimax rotation, identifying factors with eigenvalues > 1 and factor loadings > 0.50. CFA assessed model fit using χ2/df, Incremental Fit Index (IFI), Tucker Lewis Index (TLI), Comparative Fit Index (CFI), and Root Mean Square Error of Approximation (RMSEA). Convergent and discriminant validity were examined, and concurrent validity was assessed using the Pearson correlation coefficient. Internal consistency was evaluated using Cronbach’s alpha. The analyses were conducted using Amos 23.0 and IBM SPSS Statistics 29. A total of 428 pregnant Chinese women participated in the study. EFA revealed two factors, which together accounted for 59.869% of the variance. Item loadings ranged from 0.658 to 0.833. CFA results confirmed an acceptable fit for the two-factor model, with χ2/df = 3.789 (less than 5), p < 0.001, IFI = 0.892, TLI = 0.855, CFI = 0.890, and RMSEA = 0.116. Convergent validity was supported by average variance extracted (0.434–0.558) and composite reliability (0.754–0.883). Discriminant validity was established, and internal consistency was acceptable, with values ranging from 0.749 to 0.881. A significant negative correlation with perceived social support also supported concurrent validity. 52.4% of women reported moderate to high perceived stress levels (score ≥ 14). The CPSS-10 demonstrates strong psychometric properties and is a valid and reliable tool for assessing perceived stress among pregnant women in mainland China. Its use may aid in identifying stress-related risk during pregnancy and guide timely psychological support.