Generic placeholder image

Current Women`s Health Reviews

Editor-in-Chief

ISSN (Print): 1573-4048
ISSN (Online): 1875-6581

Research Article

Predictors of Early Pregnancy Fatigue among Iranian Women during the COVID-19 Pandemic: A Cross Sectional Study

Author(s): Afsaneh Veisy, Sakineh Mohammad Alizadeh Charandabi, Shamci Abbas-Alizadeh, Fariba Ghaderi, Mahmonir Haghighi and Mojgan Mirghafourvand*

Volume 19, Issue 2, 2023

Published on: 27 July, 2022

Article ID: e180522204997 Pages: 9

DOI: 10.2174/1573404818666220518154900

Price: $65

Abstract

Background: Fatigue is a common problem in pregnancy and is associated with negative outcomes.

Objectives: This study aimed to determine the predictors of fatigue in pregnant women.

Methods: This cross-sectional study was conducted on 150 pregnant women with a gestational age of 12-18 weeks visiting the healthcare centers in Mahabad-Iran, 2021. Fatigue was assessed via the modified Multidimensional Assessment of Fatigue (MAF) checklist, depression via the Edinburgh Postnatal Depression Scale (EPDS), stress and anxiety via Depression, Anxiety and Stress Scale-21 (DASS-21), well-being via WHO-5, and positive and negative affect via International Positive and Negative Affect Schedule-Short Form (I-PANAS-SF). The general linear model was used to estimate the degree of the effect of each independent variable (sociodemographic characteristics, depression, stress, anxiety, positive and negative affect, and well-being) on the dependent variable (early pregnancy fatigue).

Results: The mean (SD) fatigue score was 21.91 (7.07), within the 0-50 possible range. The majority of pregnant women (87.3%) suffered from fatigue. Based on the Pearson or Spearman correlation analysis, a significant correlation was observed between fatigue and depression (r= 0.334, P<0.001), anxiety (r= 0.327, P<0.001), stress (r=0.329, P< 0.001), well-being (r= -0.279, P<0.001), and negative affect (r= 0.308, P<0.001). Based on the adjusted general linear model, the education, stress and negative affect variables were predictors of fatigue.

Conclusion: The education, stress and negative affect predict fatigue in pregnant women, and their identification contributes to the designation of interventions to mitigate fatigue in this group. More studies are required to identify the causes of fatigue during pregnancy.

Keywords: Fatigue, mental health, pregnancy, COVID-19, predictors, pandemic.

Graphical Abstract
[1]
Wijeratne C, Hickie I, Brodaty H. The characteristics of fatigue in an older primary care sample. J Psychosom Res 2007; 62(2): 153-8.
[http://dx.doi.org/10.1016/j.jpsychores.2006.09.011] [PMID: 17270573]
[2]
Ricci JA, Chee E, Lorandeau AL, Berger J. Fatigue in the U.S. workforce: Prevalence and implications for lost productive work time. J Occup Environ Med 2007; 49(1): 1-10.
[http://dx.doi.org/10.1097/01.jom.0000249782.60321.2a] [PMID: 17215708]
[3]
Kahol K, Leyba MJ, Deka M, et al. Effect of fatigue on psychomotor and cognitive skills. Am J Surg 2008; 195(2): 195-204.
[http://dx.doi.org/10.1016/j.amjsurg.2007.10.004] [PMID: 18194679]
[4]
Cahill CA. Differential diagnosis of fatigue in women. J Obstet Gynecol Neonatal Nurs 1999; 28(1): 81-6.
[http://dx.doi.org/10.1111/j.1552-6909.1999.tb01968.x] [PMID: 9924868]
[5]
Tsai SY, Lin JW, Kuo LT, Thomas KA. Daily sleep and fatigue characteristics in nulliparous women during the third trimester of pregnancy. Sleep 2012; 35(2): 257-62.
[http://dx.doi.org/10.5665/sleep.1634] [PMID: 22294816]
[6]
Poole CJ. Fatigue during the first trimester of pregnancy. J Obstet Gynecol Neonatal Nurs 1986; 15(5): 375-9.
[http://dx.doi.org/10.1111/j.1552-6909.1986.tb01409.x] [PMID: 3639925]
[7]
Cheng CY, Chou YH, Wang P, Tsai JM, Liou SR. Survey of trend and factors in perinatal maternal fatigue. Nurs Health Sci 2015; 17(1): 64-70.
[http://dx.doi.org/10.1111/nhs.12149] [PMID: 24835296]
[8]
Johnson RM, Doshi P, Healy D. Covid-19: Should doctors recommend treatments and vaccines when full data are not publicly available? BMJ 2020; 370: m3260.
[http://dx.doi.org/10.1136/bmj.m3260] [PMID: 32839164]
[9]
Wang C, Pan R, Wan X, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health 2020; 17(5): 1729.
[http://dx.doi.org/10.3390/ijerph17051729] [PMID: 32155789]
[10]
Taubman-Ben-Ari O, Chasson M, Abu Sharkia S, Weiss E. Distress and anxiety associated with COVID-19 among Jewish and Arab pregnant women in Israel. J Reprod Infant Psychol 2020; 38(3): 340-8.
[http://dx.doi.org/10.1080/02646838.2020.1786037] [PMID: 32573258]
[11]
Zahmatkesh R. The impact of COVID-19 outbreak on the mental health of the pregnant women: A systematic review. Int J Pediatr 2021; 9(3): 13185-92.
[http://dx.doi.org/10.22038/IJP.2020.51632.4106]
[12]
Hossain N. Perceptions, generalized anxiety and fears of pregnant women about corona virus infection in the heart of pandemic. Res Sq 2020; pp. 1-16.
[http://dx.doi.org/10.21203/rs.3.rs-32235/v1]
[13]
Morgul E, Bener A, Atak M, et al. COVID-19 pandemic and psychological fatigue in Turkey. Int J Soc Psychiatry 2021; 67(2): 128-35.
[http://dx.doi.org/10.1177/0020764020941889] [PMID: 32650681]
[14]
Banafsheh E, Salari P, Hebrani P. Relationship between maternal fatigues during pregnancy with postpartum blues. Iran J Obstet Gynecol Infert 2013; 16(54): 7-15.
[http://dx.doi.org/10.22038/IJOGI.2013.1168]
[15]
Corwin EJ, Arbour M. Postpartum fatigue and evidence-based interventions. MCN Am J Matern Child Nurs 2007; 32(4): 215-20.
[http://dx.doi.org/10.1097/01.NMC.0000281959.71454.e5] [PMID: 17667284]
[16]
Bates DW, Schmitt W, Buchwald D, et al. Prevalence of fatigue and chronic fatigue syndrome in a primary care practice. Arch Intern Med 1993; 153(24): 2759-65.
[http://dx.doi.org/10.1001/archinte.1993.00410240067007]
[17]
Engberg I, Segerstedt J, Waller G, Wennberg P, Eliasson M. Fatigue in the general population- associations to age, sex, socioeconomic status, physical activity, sitting time and self-rated health: The northern Sweden MONICA study 2014. BMC Public Health 2017; 17(1): 654.
[http://dx.doi.org/10.1186/s12889-017-4623-y] [PMID: 28806984]
[18]
Gentile S. Untreated depression during pregnancy: Short- and long-term effects in offspring. A systematic review. Neuroscience 2017; 342: 154-66.
[http://dx.doi.org/10.1016/j.neuroscience.2015.09.001] [PMID: 26343292]
[19]
Woody CA, Ferrari AJ, Siskind DJ, Whiteford HA, Harris MG. A systematic review and meta-regression of the prevalence and incidence of perinatal depression. J Affect Disord 2017; 219: 86-92.
[http://dx.doi.org/10.1016/j.jad.2017.05.003] [PMID: 28531848]
[20]
Lebel C, MacKinnon A, Bagshawe M, Tomfohr-Madsen L, Giesbrecht G. Elevated depression and anxiety symptoms among pregnant individuals during the COVID-19 pandemic. J Affect Disord 2020; 277: 5-13.
[http://dx.doi.org/10.1016/j.jad.2020.07.126] [PMID: 32777604]
[21]
Belza BL, Henke CJ, Yelin EH, Epstein WV, Gilliss CL. Correlates of fatigue in older adults with rheumatoid arthritis. Nurs Res 1993; 42(2): 93-9.
[http://dx.doi.org/10.1097/00006199-199303000-00006] [PMID: 8455994]
[22]
Neuberger GB. Measures of fatigue: The fatigue questionnaire, fatigue severity scale, multidimensional assessment of fatigue scale, and short form‐36 vitality (energy/fatigue) subscale of the short form health survey. Arthritis Rheum 2003; 49(S5): S175-83.
[http://dx.doi.org/10.1002/art.11405]
[23]
Mortazavi F, Borzoee F. Fatigue in pregnancy: The validity and reliability of the Farsi multidimensional assessment of fatigue scale. Sultan Qaboos Univ Med J 2019; 19(1): e44-50.
[http://dx.doi.org/10.18295/squmj.2019.19.01.009] [PMID: 31198595]
[24]
Daneshmandi H, Choobineh A, Ghaem H. Psychometric properties of the Persian version of the “multidimensional assessment of fatigue scale”. Int J Prev Med 2019; 10(1): 53.
[http://dx.doi.org/10.4103/ijpvm.IJPVM_172_17] [PMID: 31143427]
[25]
Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item edinburgh postnatal depression scale. Br J Psychiatry 1987; 150(6): 782-6.
[http://dx.doi.org/10.1192/bjp.150.6.782] [PMID: 3651732]
[26]
Shakeel N, Eberhard-Gran M, Sletner L, et al. A prospective cohort study of depression in pregnancy, prevalence and risk factors in a multi-ethnic population. BMC Pregnancy Childbirth 2015; 15(1): 5.
[http://dx.doi.org/10.1186/s12884-014-0420-0] [PMID: 25616717]
[27]
Galini Moghadam T. Validation of the Persian version of edinburgh postnatal depression scale in Iranian women. Int J Pediatr 2020; 8(9): 12081-9.
[http://dx.doi.org/10.22038/IJP.2020.51174.4063]
[28]
Kheirabadi GR, Maracy MR, Akbaripour S, Masaeli N. Psychometric properties and diagnostic accuracy of the Edinburgh postnatal depression scale in a sample of Iranian women. Iran J Med Sci 2012; 37(1): 32-8.
[PMID: 23115428]
[29]
Montazeri A, Torkan B, Omidvari S. The Edinburgh Postnatal Depression Scale (EPDS): Translation and validation study of the Iranian version. BMC Psychiatry 2007; 7(1): 11.
[http://dx.doi.org/10.1186/1471-244X-7-11] [PMID: 17408479]
[30]
Ahmadi Kani GA. GoliZadeh Z. Validation of Edinburgh Postpartum Depression Scale (EPDS) for screening postpartum depression in Iran. J Psychiatry 2015; 3(3): 1-10.
[31]
Lovibond PF, Lovibond SH. The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the beck depression and anxiety inventories. Behav Res Ther 1995; 33(3): 335-43.
[http://dx.doi.org/10.1016/0005-7967(94)00075-U] [PMID: 7726811]
[32]
Sahebi A, Asghari MJ, Salari RS. Validation of depression anxiety and stress scale (DASS-21) for an Iranian population. 2005; 36-54.
[33]
Asghari A, Saed F, Dibajnia P. Psychometric properties of the depression anxiety stress scales-21 (DASS-21) in a non-clinical Iranian sample. Int J Psychol 2008; 2(2): 82-102.
[34]
Watson D, Clark LA, Tellegen A. Development and validation of brief measures of positive and negative affect: The PANAS scales. J Pers Soc Psychol 1988; 54(6): 1063-70.
[http://dx.doi.org/10.1037/0022-3514.54.6.1063] [PMID: 3397865]
[35]
Thompson ER. Development and validation of an internationally reliable short-form of the Positive And Negative Affect Schedule (PANAS). J Cross Cult Psychol 2007; 38(2): 227-42.
[http://dx.doi.org/10.1177/0022022106297301]
[36]
Heshmati R. Factor structure of short form of the international scale of positive and negative affect in patients with coronary artery. J Appl Psychol 2014; 8(2): 56-41.
[37]
Dehshiri G, Mousavi S. An investigation into psychometric properties of Persian version of world health organization Five Well-being Index 2016.
[http://dx.doi.org/10.22075/jcp.2017.2237]
[38]
World Health Organization. The International Statistical Classification of Diseases and Health Related Problems ICD-10: Tenth Revision. Volume 1: Tabular List: World Health Organization 2004.
[http://dx.doi.org/10.1080/14767058.2016.1190821]
[39]
Topp CW. Østergaard SD, Søndergaard S, Bech P. The WHO-5 well-being index: A systematic review of the literature. Psychother Psychosom 2015; 84(3): 167-76.
[http://dx.doi.org/10.1159/000376585] [PMID: 25831962]
[40]
Mortazavi F, Mousavi SA, Chaman R, Khosravi A. Validation of the world health organization-5 well-being index; assessment of maternal well-being and its associated factors. Turk Psikiyatr Derg 2015; 26(1): 48-55.
[PMID: 25742037]
[41]
VanVoorhis CW, Morgan BL. Understanding power and rules of thumb for determining sample sizes. Tutor Quant Methods Psychol 2007; 3(2): 43-50.
[http://dx.doi.org/10.20982/tqmp.03.2.p043]
[42]
Allameh SF, Nemati S, Ghalehtaki R, et al. Clinical characteristics and outcomes of 905 COVID-19 patients admitted to Imam Khomeini hospital complex in the capital city of Tehran, Iran. Arch Iran Med 2020; 23(11): 766-75.
[http://dx.doi.org/10.34172/aim.2020.102] [PMID: 33220695]
[43]
Hamzehgardeshi Z, Omidvar S, Amoli AA, Firouzbakht M. Pregnancy-related anxiety and its associated factors during COVID-19 pandemic in Iranian pregnant women: A web-based cross-sectional study. BMC Pregnancy Childbirth 2021; 21(1): 208.
[http://dx.doi.org/10.1186/s12884-021-03694-9] [PMID: 33722198]
[44]
Shi L, Lu ZA, Que JY, Huang XL. Prevalence of and risk factors associated with mental health symptoms among the general population in China during the coronavirus disease 2019 pandemic. JAMA Netw Open 2020; 3(7): e2014053.
[http://dx.doi.org/10.1001/jamanetworkopen.2020.14053]
[45]
Ahmadi A. Effects of psychological interventions on postpartum depression, anxiety and infants’ weight in primipara women. Prev Care Nurs Midwifery J 2014; 4(1): 19-31.
[46]
Sharpe M, Wilks D, Fatigue BMJ. 2002; 325(7362): 480-3.
[http://dx.doi.org/10.1136/bmj.325.7362.480] [PMID: 12202331]
[47]
Zib M, Lim L, Walters WA. Symptoms during normal pregnancy: A prospective controlled study. Obstet Gynaecol 1999; 39(4): 401-10.
[http://dx.doi.org/10.1111/j.1479-828X.1999.tb03122.x] [PMID: 10687753]
[48]
Paarlberg KM, Vingerhoets AJ, Passchier J, Dekker GA, Van Geijn HP. Psychosocial factors and pregnancy outcome: A review with emphasis on methodological issues. J Psychosom Res 1995; 39(5): 563-95.
[http://dx.doi.org/10.1016/0022-3999(95)00018-6] [PMID: 7490693]
[49]
Fairbrother N, Hutton EK, Stoll K, Hall W, Kluka S. Psychometric evaluation of the multidimensional assessment of fatigue scale for use with pregnant and postpartum women. Psychol Assess 2008; 20(2): 150-8.
[http://dx.doi.org/10.1037/1040-3590.20.2.150] [PMID: 18557692]
[50]
Behrenz KM, Monga M. Fatigue in pregnancy: A comparative study. Am J Perinatol 1999; 16(4): 185-8.
[http://dx.doi.org/10.1055/s-2007-993855] [PMID: 10458531]
[51]
Corwin EJ, Brownstead J, Barton N, Heckard S, Morin K. The impact of fatigue on the development of postpartum depression. J Obstet Gynecol Neonatal Nurs 2005; 34(5): 577-86.
[http://dx.doi.org/10.1177/0884217505279997] [PMID: 16227513]
[52]
Olff M. Stress, depression and immunity: The role of defense and coping styles. Psychiatry Res 1999; 85(1): 7-15.
[http://dx.doi.org/10.1016/S0165-1781(98)00139-5] [PMID: 10195312]
[53]
Salari P. On the relationship between maternal fatigue and postpartum depression. J Fundamentals Mental Health 2009; 11(44): 11-302.
[http://dx.doi.org/10.22038/JFMH.2009.1214]
[54]
Ozgoli G, Nureyazdan S, Shams J. Fatigue in pregnant employed women Adv Nurs midwifery 2008; 17(59): 12-8.
[55]
Mahmoodi Z, Dolatian M, Mirabzadeh A, Alavi Majd H, Moafi F, Ghorbani M. The relationship between household socioeconomic status and mental health in women during pregnancy: A path analysis. Iran J Psychiatry Behav Sci 2017; 11(2): e8823.
[http://dx.doi.org/10.5812/ijpbs.8823]
[56]
Varghese NE, Sabat I. Neumann-Böhme S, et al. Risk communication during COVID-19: A descriptive study on familiarity with, adherence to and trust in the WHO preventive measures. PLoS One 2021; 16(4): e0250872.
[http://dx.doi.org/10.1371/journal.pone.0250872] [PMID: 33914814]
[57]
Chou FH, Avant KC, Kuo SH, Fetzer SJ. Relationships between nausea and vomiting, perceived stress, social support, pregnancy planning, and psychosocial adaptation in a sample of mothers: A questionnaire survey. Int J Nurs Stud 2008; 45(8): 1185-91.
[http://dx.doi.org/10.1016/j.ijnurstu.2007.08.004] [PMID: 17905253]
[58]
Power K. The COVID-19 pandemic has increased the care burden of women and families. Sustain Sci Pract Policy 2020; 16(1): 67-73.
[http://dx.doi.org/10.1080/15487733.2020.1776561]
[59]
Simonovic D. States Must Combat Domestic Violence in the Context of COVID-19 Lockdowns-UN Rights Expert Geneva United Nations Office of the High Commissioner for Human Rights. 2020.

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy