Comparison status and factors of pregnancy stress among pregnant women with second child between advanced maternal age and reproductive age: a cross-sectional study

With the implementation of China’s two-child policy and the rising trend of advanced maternal age, pregnancy stress in women with a second child has become a significant concern. To investigate the status and factors of pregnancy stress in women with second child between advanced maternal age and reproductive age in China. A cross-sectional study was conducted in Changsha. A total of 767 pregnant women with second child, including 237 advanced maternal age and 530 reproductive age pregnant women, agreed to participate in this study. It was collected using a socio-demographic and obstetric characteristics questionnaire and the Pregnancy Stress Scale. We conducted a descriptive analysis to characterize pregnancy stress levels and related factors. Univariate analysis was performed to examine the associations between socio-demographic/obstetrical characteristics and pregnancy stress. Additionally, linear regression was utilized to identify significant factors associated with pregnancy stress. The pregnancy stress levels of both groups were at a mild to moderate, and there was no significant difference in the total stress score and factor 1 (“parenthood recognition”), factor 2 (“assurance of the health and safety of mother and fetus”), and factor 3 (“changes of body shape and physical activities of mother”) between two groups (p > 0.05). However, there was a significant difference in the factor 4 (“other”) (p < 0.05). The primary source of stress for both groups was factor 2 (“assurance of the health and safety of mother and fetus”) (1.8 ± 0.6); The factors influencing stress for advanced maternal age pregnant women with second child were “relationship with their spouse”, “family financial burden”, and “fertility desire”. For reproductive age pregnant women with second child, the factors were “family financial burden”, “fertility desire”, “relationship with parents-in-law”, “gender of their first child”, “gender preference”, and “relationship with their spouse”. There were both the same and different factors of stress for advanced maternal age and reproductive age pregnant women with second child, targeted interventions should be taken to alleviate pregnancy stress for them.