Conference PaperPDF Available

Analysis of Physical Activity Against Stress Levels in Pregnant Women at Plaju Health Center

Authors:
Analysis of Physical Activity Against Stress Levels in Pregnant
Women at Plaju Health Center
The results showed that pregnant women
working with excessive physical activity at the
third trimester of pregnancy who have a history
of the disease have a higher risk of being
exposed to stress in pregnancy. Plaju Health
Center is expected to open counseling
especially for pregnant women who work on
the balance of physical activity by paying
attention to gestational age, history of illness to
reduce stress levels.
Keywords: physical activity, stress level
literature: 75 (1997-2019)
1 INTRODUCTION
Maternal Mortality Rate (MMR) describes the
number of women who died related to pregnancy
disorders or treatment (not including accident or
incidental cases) during pregnancy, childbirth and in
the postpartum period, 42 days after
delivery.(Kemenkes, 2015) The most common
causes of maternal death in Indonesia are direct
obesity with bleeding 28%, hypertension 24%,
infections 11%, while indirect causes are trauma 5%
obsetri etc. 11%(Profil Kesehatan Indonesia, 2017)
Advances in Health Sciences Research, volume 25
2nd Sriwijaya International Conference of Public Health (SICPH 2019)
Copyright © 2020 The Authors. Published by Atlantis Press SARL.
This is an open access article distributed under the CC BY-NC 4.0 license -http://creativecommons.org/licenses/by-nc/4.0/. 64
Abstract - Energy expenditure by skeletal
muscle movements includes light, moderate,
heavy, permanent, household, work and sports
activities. Pregnant women with excessive
physical activity cause tired then affect the
stress level. Conditions of anxiety or anxiety to
feeling depressed during pregnancy can activate
the hormone cortisol in the bodyand cause
complications in pregnancy and infant growth.
The purpose of the study is analyzing the
physical activity of pregnant women towards
stress levels at the Plaju Health Center in
Palembang. This quantitative research used
cross sectional study design. 156 trimester II
and III pregnant women were taken by
purposive sampling at the Plaju Public Health
Center. The results showed a significant
relationship between physical activity (p-value
= 0.035), gestational age (p-value 0.002),
occupation (p-value 0.001), income (p-value
0.018) and history of disease (p-value 0,000) on
stress levels in pregnant women. The results of
multivariate analysis found that the most
dominant variable affecting stress levels in
pregnant women was physical activity that had
been controlled by confounding variables,
namely gestational age, occupation, and disease
history ((PR = 2,225, 95% CI = 1,096 4,776).
Annisa Yusmutia
Faculty of Public Health
University of Sriwijaya
Palembang, Indonesia
annisyayusmutia@gmail.com
Novrikasari
Faculty of Public Health
University of Sriwijaya
Palembang, Indonesia
novrikasari@fkmunsri.ac.id
Yuanita Windusari
Faculty of Public Health
University of Sriwijaya
Palembang, Indonesia
ywindusari@yahoo.com
Regarding the issue of maternal mortality, the
community is suing that the target of the Sustainable
Development Goals (SDG’s) in 2030 needs to
receive special attention from all parties, both the
government and the private sector, namely reducing
the Maternal Mortality Rate (MMR) below 70
pregnant women per 100,000 live births. Data from
the National Medium-Term Development Plan
(RPJMN) in 2010 reached 346 per 100,000 live
births, the target of the RPJMN in 2011 was 306 per
100,000 live births according to the Directorate of
Maternal Health Development of the Ministry of
Health of the Republic of Indonesia. (Riset
Kesehatan Dasar, 2018). Pregnant women are one of
the groups in society who suffer the most from
health problems. During pregnancy, pregnant
women will experience physical and psychological
changes (feelings of anxiety, fear, stress, to
stress)(Guiton, 2008). Stress is the process by which
environmental demands exceed the ability or source
of an individual to overcome them which results in
psychological changes (Perceived Stress). Perceived
Stress is the ability of the brain to receive stimuli or
stimuli to pressure or burden that exceeds the ability
in one's life, which comes from knowledge and
experience to be perceived as stress (Bruce, 1998)
The source of stress, called a stressor, can come
from psychological factors such as social
relationships or life changes such as pregnancy or
daily physical activity to life problems(Folkman, S.,
& Lazarus, 1985)
Physical activity is classified as mild, moderate,
heavy, household, sedentary, work and sports. The
combination of these activity classifications is
referred to as total physical activity. Light physical
activity is defined as body movements in daily
activities such as housework and walking. Physical
activity is being defined as body movements such as
cycling, jogging, and walking fast. Heavy physical
activity is body movement that requires burning
large calories such as swimming, hiking and lifting
weights (Ml, 2019).
Physical, emotional and social changes in
pregnancy can be stressors, as well as worries about
childbirth including age during pregnancy, physical
changes, appearance, interpersonal relationships,
daily work or physical activity, medical conditions
during pregnancy or stress and fatigue so mothers
become more sensitive to emotional changes that
trigger increased stress (Lobel & Dunkel Schetter,
2016).
Occupational factors in pregnant women are one of
the factors that can make pregnant women more
stressed due to the dual role in work and family.
Pregnant women who work for a long duration also
affect stress. The longer pregnant women work, the
greater the risk for health problems such as work
stress. In this case stress can be related to the status
of work or physical activity in a day where the status
of work and physical activity can affect the level of
stress in a person's body associated with the burden
of work but stress during pregnancy can also occur
directly or indirectly can causecomplications
pregnancy. Stress increases activation of the
sympathetic nervous system. Stress causes the active
sympathetic nervous system to stimulate the
hypothalamus to release the hormone corticotropin-
releasing-factor (CRF), the pituitary releases the
hormone adenocorticotropin (ACTH) and ACTH
stimulates the adrenal glands to release adrenaline
(epinephrine) to produce cortisol. Overactive
sympathetic nervous system becomes a risk factor
for preeclampsia to hypertension(Kordiet al., 2017).
Pregnant women who experience stress can
cause the release of the hormone cortisol. The
hormone cortisol itself has an effect in inhibiting the
flow of blood to the fetus which can cause
interference with the development of the baby
(Folkman, S., & Lazarus, 1985).
Stress during pregnancy increases the risk of 1.6
times greater for hypertension and 2.9 times the risk
Advances in Health Sciences Research, volume 25
65
of preeclampsia in pregnancy (Kordi et al., 2017)).
Pregnant women who are severely depressed will be
at greater risk of preeclampsia (OR = 3.2) compared
to moderately depressed pregnant women (OR =
2.3) (Qiu et al., 2008).
During 2006 to 2017 the coverage of K4 pregnant
women health services tended to increase. When
compared with the Ministry of Health's Strategic
Plan (Renstra) target of 2017 which is 76%, the
achievements in 2017 have reached the target. The
highest K4 coverage is in the DKI Jakarta province
while South Sumatra is ranked fifth (Riset
Kesehatan Dasar, 2018).PlajuPuskesmas is one of
the Puskesmas that has the highest number of visits
of pregnant women in Palembang, reaching1.682
pregnant women1.682who visited. (Profil Kesehatan
Palembang, 2017). Based on preliminary surveys at
the Plajupuskesmas, the number of visits of pregnant
women in 2018 was 1082, then an increase in the
number of visits of pregnant women from January to
March 2019 was 1050 pregnant women.
Based on the statement above it is known that
physical activity plays a role in the emergence of
stress levels in pregnant women which may cause
indications of complications in pregnancy.
Excessive physical activity in pregnant women to
experience fatigue, anxiety, stress, anxiety can be
called an indication of the risk of risk of placental
hypoxia or disruption of uteroplacental blood flow
so that the blood volume to the placenta is reduced
and oxygen levels carried to the uterus decrease
resulting in perfusion of the atherial spirals causing
hypertension in pregnancy, preeclampsia bleeding to
eclampsia in pregnant women that cause death is a
problem that always occurs in pregnancy so the
above explanation is an indication of the importance
of conducting a study entitled "Analysis of Physical
Activity Against Stress Levels in Pregnant Women
at PuskesmasPlaju Palembang"
2.RESEARCH METHODS
2.1 Study Design and Data Collection
This research is a quantitative method research with
cross sectional analytic survey approach, which is a
study to study the correlation between the dependent
variable (stress level) and the independent variable
(physical activity of pregnant women). The
locationof the study was conducted in the
palembangplaju community health center. The
populationin this study was pregnant women
withinscope ofthe plaju health center in palembang
during the study. The sample size is calculated using
the formula of the sample size of the cross-sectional
hypothesis test design, then obtained a sample of 72
multiplied by 2 to 144the sample. 10% drop out was
added so that the number of samples became 156
samples.
2.2 Sampling Techniques
Questionnaire to measure the physical activity of
pregnant women and is standard, PPAQ (Pregnancy
Physical Activity Questionnaire) contains 36
questions to explore the intensity of physical activity
during the last 7 days before the time of research.
The intensity of physical activity that you want to
measure uses ratio data and uses the values set by
PPAQ and MET Values for American Activities.
Inclusion Criteria:
1. Pregnant Mother in the Scope of Palembang
Public Health Center
2. Pregnant Mother with Trimester 2 and 3
gestational ages
Exclusion Criteria:
1. Pregnant Mother with Trimester 1 gestational age
2.3 Data Collection Techniques
The instrument used to measure stress levels of
pregnant women using a standardized questionnaire
Advances in Health Sciences Research, volume 25
66
that is the Kessler Psychological Sitress Scale (K10)
by Kessler R. Professor of Health Care Policy from
Harvard Medical School Boston USA consists of 10
questions about anxiety and depression symptoms
experienced by a person in the last 4 weeks to look
at stress measures. Stress intensity is measured using
ratio data.
With ratings:
1 = never
2 = only occasionally
3 = sometimes
4 = often
5 = every time
The number of scores for each answer is added so
that 1 questionnaire will have a minimum value of
10 and a maximum of 50.
2.4 Data Analysis
After the data is collected then the data is
analyzed using univariate, bivariate and
multivariate. Univariate data analysis is used to
find out the frequency distribution of the
dependent variable, namely the stress level and
the independent variable, namely physical
activity, pregnant woman's age, gestational age,
occupation, income, parity status, disease
history, pregnancy exercise. Bivariate analysis
is carried out to assess the relationship or
influence between independent and dependent
variables. The results of the bivariate analysis
are presented in the table by displaying the p-
value, rario prevalence (PR), and Confidence
Interval (CI) of each variable. Multivariate
Analysis: in Multivariate analysis researchers
used a multiple logistic regression test using a
risk factor research model that aims to validly
estimate the relationship between the main
independent (physical activity) and the
dependent variable (stress level) after being
controlled by several variables that are
suspected of confounding (maternal age
pregnant, gestational age, occupation, income,
parity, history of illness, and pregnancy
exercise).
3. RESULTS
3.1. Univariate Analysis
3.1.1 Characteristics of Research Respondents
After conducting interviews and examinations on
156 pregnant women at the PuskesmasPlaju
Palembang, the following results were obtained:
Table 3.1 Frequency Distribution of Dependent
Variables and Independent Variables
Variable
Frequency
%
Stress Level
Stress
No stress
89
67
57,1
42,9
Total Physical
Activity
Over
Normal
78
78
50
50
Sedentary
Physical Activity
Over
Normal
78
78
50
50
Light Physical
Activity
Over
Normal
78
78
50
50
Medium Physical
Activity
Over
Normal
74
82
47,4
52,6
Heavy Physical
Activity
Over
Normal
71
85
45,5
54,5
Household
Physical Activity
Over
Normal
78
78
50
50
Physical Activity
Work
Over
Normal
46
110
29,5
70,5
Advances in Health Sciences Research, volume 25
67
Physical Activity
Sports
Over
Normal
71
85
45,5
54,5
Age
High risk
Low risk
32
124
20,5
79,5
Age of
Pregnancy
Trimester 2
Trimester 3
46
110
29,5
70,5
Occupation
Work
Does not work
86
70
55,1
44,9
Income
< UMR
> UMR
89
67
57,1
42,9
Paritas
Primipara
Multipara
100
56
64,1
35,9
Disease History
Chronicles
No Chronicles
38
118
24,2
75,6
Pregnancy
exercise
Yes
No
15
141
9,6
90,4
Based on Table 3.1 Pregnant women who
experienced stress from 156 respondents by 89
(57.1%), who had total physical activity in
excess of 78 (50%), who had excess light
physical activity as many as 78 (50%), who had
physical activity 78 (50%) excessive sedentary,
74 (47.4%) of moderate moderate physical
activity, 71 (45.5%) of excessive heavy
physical activity, 78 (50.5%) excessive physical
activity of the household %), those who have
physical activity in excess of 46 jobs (29.5%),
who have physical activity in excess of 71
sports (45.5%), who have a high risk age of 32
(20.5), who have an advanced age trimester 3
110 (70.5), 86 (55.1) working, having 89
<UMR income (89.17), having 56 (35.9)
multiparous parity status, having a history of
disease chronicles as much as 38 (24.2), which
does not accompany pregnancy exercises as
many as 141 (90, 4).
3.2 Bivariate Analysis
Table 3.2 Bivariate Analysis of Stress Levels in
Pregnant Women in PuskesmasPlajuPakembang
From Table 3.2 it is known that physical activity
has a p-value of 0.035 (p-value <0.05) which means
there is a relationship between physical activity and
stress levels in pregnant women at the Plaju Health
Center in Palembang. Prevalence Ratio (PR) value
indicates 1988 means that pregnant women who
Variable
Am
ount
p-
value
PR
(95%CI)
Low
High
n
n
%
n
%
0,035
1,988
(1,044-
3,786)
Physycal
Activity
Over
(>144,5)
51
65,4
27
34,6
78
Normal
(≤144,5)
38
48,7
40
51,3
78
Age
High Risk
18
56,2
14
43,8
32
0,918
0,960
(0,438
-2,102)
Low Risk
71
58,1
53
41,9
124
Age Of
pregnancy
Trimester 2
35
76,1
11
23,9
46
0,002
3,300
(1,522-
7,153)
Trimester 3
54
49,1
56
50,9
110
Occupatio
n
Work
59
68,6
27
31,4
86
0,001
2,914
(1,511-
5,620)
Does not
work
30
42,9
40
57,1
70
Income
<UMR
58
65,2
31
34,8
89
0,018
2,173
(1,136-
4,156)
>UMR
31
46,3
36
53,7
67
Paritas
Primipara
55
55,0
45
45,0
100
0,489
1,264
(0,650-
2,460)
Multipara
34
60,7
22
39,3
56
Disease
History
chronicles
31
81,6
7
18,4
38
0,000
4,581
(1,870-
11,224)
No
chronicles
58
49,2
60
50,8
118
Pregnancy
exercise
No
81
57,4
60
42,6
141
0,760
0,847
(0,291-
2,463)
Yes
8
53,3
7
46,7
15
Advances in Health Sciences Research, volume 25
68
have physical activity are 1,988 times more at risk of
experiencing stress than pregnant women who have
normal physical activity (95% CI = 1,044-3,786).
The population is believed to be 95% that pregnant
women who have physical activity are more at risk
of experiencing stress than pregnant women who
have normal physical activity with a range of 1,044
to 3,786. Gestational age has a p-value of 0.918 (p-
value> 0.05) which means there is no relationship
between the age of pregnant women with stress
levels in pregnant women at the Plaju Health Center
in Palembang. Gestational age has a p-value of
0.002 (p-value <0.05), which means there is a
relationship between gestational age and stress
levels in pregnant women at the Plaju Health Center
in Palembang. The value of Prevalence Ratio (PR)
shows 3,300, meaning that pregnant women with
trimester 3 gestational age are 3,300 times more
likely to experience stress than pregnant women
with trimester 2 gestational age (95% CI = 1,522-
7,153). The population is believed to be 95% that
pregnant women with trimester 3 gestational age are
at risk for experiencing stress compared to pregnant
women with gestational age trimester 2 with a range
of 1.522 to 7.153. Work has a p-value of 0.001 (p-
value <0.05) which means there is a relationship
between work and stress levels in pregnant women
at the Plaju Health Center in Palembang. The value
of the Prevalence Ratio (PR) shows the number
2.914 means that pregnant women who work at risk
are 2,914 times higher to experience stress than
pregnant women who do not work (95% CI = 1,511-
5,620). In the population it is believed that 95% of
working pregnant women are at risk of experiencing
stress compared to non-working pregnant women
with a range of 1,511 to 5,620. income has a p-value
of 0.018(p-value <0.05) which means there is a
relationship between income and stress levels in
pregnant women at the Plaju Health Center in
Palembang. The value of Prevalence Ratio (PR)
shows 2,173 meaning that pregnant women who
have an income <UMR are 1,433 times higher risk
of experiencing stress than pregnant women who
have an income> UMR (95% CI = 1,136-4,156).
The population is believed to be 95% that pregnant
women who have an income <UMR are at risk of
experiencing stress compared to pregnant women
who have an income> UMR with a range of 1.136 to
4.156. Parity has a p-value of 0.489 (p-value> 0.05)
which means there is no relationship between parity
status and stress levels in pregnant women at the
Plaju Health Center in Palembang. History of the
disease has a p-value of 0,000 (p-value> 0.05) which
means there is a relationship between the history of
the disease with stress levels in pregnant women at
the Plaju Health Center in Palembang. The value of
the Prevalence Ratio (PR) shows the number 4.581
means that pregnant women who have a history of
chronic disease are 4.581 times higher risk of
experiencing stress than pregnant women who have
no history of chronic disease (95% CI = 1.870-
11.224). The population is believed to be 95% that
pregnant women who have a history of chronic
disease are at risk of experiencing stress compared
to pregnant women who have no history of chronic
diseases with a range of 1,870 to 11,224. Pregnant
exercise has a p-value of 0.760 (p-value> 0.05)
which means there is no relationship between
pregnancy exercise with stress levels in pregnant
women at the Plaju Health Center in Palembang.
3.3 Multivariate Analysis
Initial Modeling (Full Model)
initial modeling (full model) is a step that is
carried out to include all research variables. The
Advances in Health Sciences Research, volume 25
69
following is the initial multivariate modeling serving
table, namely:
3.3 Early Modeling Table (Full Model)
Multivariate Analysis
Variabel
p-value
PR
Crude
95% CI
Lower
Upper
Physical
activity
0,027
2,345
1,101
4,994
Age Of
Pregnancy
0,032
2,518
1,084
5,849
Occupation
0,040
2,103
1,000
4,420
Income
0,247
1,543
0,741
3,216
Disease
History
0,019
3,247
1,218
8,656
Based on Table 3.3 it is known that physical activity
has a p-value = 0.027 that value is smaller than α
(0.05). This shows that there is a significant
relationship between physical activity and stress
levels in pregnant women after being controlled by
several variables suspected as confounding variables
(PR = 2.345; 95% CI = 1,101 - 4,994).
Change in Prevalence Ratio (PR)
Confounding testing is carried out to find out the
variables that affect physical activity on stress
levels, by issuing variables that are suspected as
confounders that have a p-value> 0.05, then
calculating the change in PR on the main
independent variable. If the variable that has been
released causes a change in PR 10% in the main
independent variable, then the variable that has been
issued is proven to be a confounding variable, but if
the main independent variable experiences a PR
change of <10%, then the variable is not a
confounding variable.
Table 3.4 Table n changes in PR for variables
that affect physical activity on stress levels.
Variable
Physical activity
Change in
PR Value
(%)
information
PR
Crude
PR
Adjusted
Physical activity
2,345
2,225
5,117
Not
confounding
Occupation
2,103
2,195
4,375
Not
confounding
Age Of
Pregnancy
2,518
2,509
0,357
Not
confounding
Disease History
3,247
3,129
3,634
Not
confounding)
Based on the Table 3.4 it is known that the
income variable which has a p-value> 0.05 has been
excluded from modeling but does not cause changes
in PR ≥10% means the non-confounding variable
and is not related to physical activity on stress levels
in pregnant women at Plaju Health Center
Palembang.
Final Model
The final model is presented to find out the most
dominant variables from the multivariate analysis in
the Physical Activity research on Stress Levels in
pregnant women at Plaju Palembang Health Center
Table 3.5 Table of the Final Model (Final
Model) Multivariate Analysis
Variable
p-
value
PR
Adjusted
95% CI
Lower
Upper
Physical
Activity
0,048
2,225
1,006
4,076
Age Of
Pregnancy
0,028
2,509
1,106
5,692
Occupation
0,030
2,195
1,081
4,456
Disease
History
0,019
3,129
1,210
8,089
Based on Table 3.5 it is known that the p-value of
physical activity is 0.048 which means that Ho is
rejected because the value is smaller than the value
of α (0.05), thus indicating that there is a significant
relationship between physical activity and Stress
Level after being controlled by
Advances in Health Sciences Research, volume 25
70
variablesconfounding such as gestational age,
occupation and disease history (PR = 2,025, 95% CI
= 1,006 - 4,076).
4. DISCUSSION
4.1 Stress Levels with Physical Activity in
Pregnant Women at PuskesmasPlaju
Palembang
In the study, a bivariate test between stress
levels and total physical activity on pregnant women
obtained a P. value of 0.035 (p-value <0.05), which
means there is a relationship between physical
activity and stress levels in pregnant women at the
Plaju Health Center in Palembang. The value of
Prevalence Ratio (PR) shows 1,988 means that
pregnant women who have physical activity are at
risk 1,988 times more likely to experience stress
than pregnant women who have normal physical
activity (95% CI = 1,044-3,786). The population is
believed to be 95% that pregnant women who have
physical activity are more at risk of experiencing
stress than pregnant women who have normal
physical activity with a range of 1,044 to 3,786.
Total excess physical activity here refers to physical
activity in pregnant women, namely permanent
physical activity (70.5%), mild physical activity
(78.2%), moderate physical activity (64.9%), heavy
physical activity (53, 5%), household physical
activity (70.5%), work physical activity (60.9%),
and physical sports activity (62%).
This is in line with the theory of physical activity
defined as body movements produced by contraction
of skeletal muscles and can increase the body's
energy. This physical activity encompasses a variety
of body movements ranging from mild, permanent,
moderate, heavy, household, work and sports
activities. Some researchersrecommend that
motherpregnant do regular physical exercise during
pregnancy, but physical activity is carried out in
excess and makes pregnant women tired can cause
disruption of blood pressure so that the occurrence
of fatigue both physically and
psychologically(Bobak, 2014)
The results of this study are in line with the results
of the study (Syahitdah, Rohmah and Nissa, 2017)
published in the Indonesian Journal of Nutrition,
namely that physical activity has a significant
relationship to diastolic blood pressure (p <0.05).
This research shows that it means the higher / excess
physical activity the higher the diastolic blood
pressure. This blood pressure study is influenced by
the condition of someone who tends to experience
stress. So it can be concluded that if excessive
physical activity can create sustained stress resulting
in the hormone adrenaline is released then it will
increase heart rate so that blood pressure rises
resulting in hypertension. Stress conditions increase
sympathetic nerve activity which then increases
blood pressure gradually, meaning that stress is
feeling tired, afraid and anxious from one's body's
feelings about changes in their environment.
Naturally under these conditions a person will feel a
faster heartbeat and cold sweats to flow to the nape
of the neck, anxiety, fear, stress, to the feeling of
hopelessness that is felt.
The results of this study are also in line with the
results (Idalia Garza Veloz, 2017) involving 321
pregnant women in Mexico found that excessive
physical activity in pregnant women causes stress
(social dysfunction, acute somatic disorders, anxiety
and
Insomnia) can be at risk of gestational
hypertension, pre-eclampsia to eclampsia in
pregnant women. Pre-eclampsia is a complex
condition associated with significant pathological
Advances in Health Sciences Research, volume 25
71
changes in maternal and fetal blood vessels and the
placenta, including decidua arteriolopathy,
infarction, ischemic changes and abruption,
therefore it is not surprising that perinatal outcomes
are influenced by this syndrome, especially in this
case. Other pre-eclampsia is commonly associated
with placental lesions. Underlying vascular
manifestations, and the presence of oxidative stress
and endothelial damage affect uteroplacental
circulation and cause fetal growth restriction with
hypoxia that underlies acidosis. In infants will cause
prematurity birth which gives the impact of
asphyxia, low birth weight, and other complications
resulting in death while in preeclampsia mothers can
occur eclampsia (pregnancy spasms) which results
in death(Sembiring et al., 2018).
4.2 Stress Levels with Age in Pregnant
Women at PuskesmasPlaju Palembang
The age of pregnant women in this study is
high risk, that is <17 years and> 35 years there are
32 (20.5%) of which> 35 years are 35 pregnant
women and <17 years ie 1 pregnant woman aged 15
years. For the age of pregnant women with low risk
with age categories between 17-35 years there were
124 (79.5%) of the total 156 respondents of pregnant
women in the public health center in Palembang. But
in this study it was found that the statistical test
results obtained a p-value of 0.918 (p-value> 0.05)
which means there is no relationship between the
age of pregnant women and the level of stress in
pregnant women at the Plaju Health Center in
Palembang.
Pregnancy does indeed affect the cause of maternal
death from reproductive factors. In the healthy
reproduction period, it is known that the age of
pregnant women at risk is <17 years and> 35 years.
Pregnant women aged <17 years can cause many
problems because it can affect organs such as the
uterus, even babies born can be premature and low
birth weight babies. This is caused because women
who become pregnant at a young age have not been
able to supply food properly from their bodies to the
fetus (marmi, 2012). Pregnancy at this age will also
cause fear of pregnancy and childbirth, this is
because at this age the mother is not ready to have
children and the reproductive organs are not ready
for pregnancy (prawihardjo, 2008)(Prawihardjo,
2012).
Age> 35 years will cause anxiety to pregnancy and
childbirth and maternal reproduction equipment too
old and have a great tendency for the occurrence of
high maternal blood pressure so that it can result in
conditions of preeclampsia to hypertension in
pregnant women which can cause bleeding and early
labor. (kristyanasari, 2010).
Conditions of anxiety and fear based on the results
of previous studies This is not in line with this study
because this study found that there was no effect
between the age of pregnant women with stress
levels. Because based on the condition in the study
of pregnant women with age <17 years only 1
person is found that is the age of 15 years after
conducting research in the stress level questionnaire
interview obtained mild stress level category due to
forms of anxiety, fear and anxiety caused by giving
birth to the first child. At the age of> 35 years found
31 people with only 18 people who have stress. 18
of those pregnant women indicated stress because
they had a history of illness or certain medical
recordscause respondents to experience anxiety,
fear, anxiety until the indicated mild stress category.
Parties have also marked the health center by giving
a yellow medical card (motherpregnant who have
certain medical records or history).
Advances in Health Sciences Research, volume 25
72
In pregnant women who do not have medical
records but at age at risk of pregnancy there are 14
pregnant women and do not experience stress due to
the results of research through questionnaires that
they are accustomed to being pregnant with the
meaning of not giving birth to their first child plus
they have no complaints or history of certain
diseases so indicated no stress and tends to enjoy the
process of pregnancy.
In pregnant women aged 17-35 years, 71 stressed
pregnant mothers and 53 stressed non-pregnant
women due to stress in pregnant women due to other
factors namely excessive physical activity, work,
income, gestational age, history of illness or
pregnancy exercise.
4.3 Stress Level with Pregnancy Age for Pregnant
Women at PuskesmasPlaju Palembang
In the statistical test results obtained p-value of
0.002 (p-value <0.05) which means there is a
relationship between gestational age and stress
levels in pregnant women at the Plaju Health Center
in Palembang. The value of Prevalence Ratio (PR)
shows 3,300, meaning that pregnant women with
trimester 3 gestational age are 3,300 times more
likely to experience stress than pregnant women
with trimester 2 gestational age (95% CI = 1,522-
7,153). The population is believed to be 95% that
pregnant women with trimester 3 gestational age are
at risk for experiencing stress compared to pregnant
women with gestational age trimester 2 with a range
of 1.522 to 7.153.
Physiological changes that occur during pregnancy,
have a pathological impact on pregnant women. In
the second trimester the body of pregnant women
has begun to adapt to nausea and vomiting, but in
the third trimester complaints due to enlargement of
the stomach, anatomical changes and hormonal
changes will cause complaints in pregnant women
(Annemarie Hennessy, S. Ananth Karumanchi,
2017)
These complaints include low back pain, shortness
of breath, varicose veins, haemorrhoids, sleep
disorders and are definitely psychologically
experiencing anxiety, fear, anxiety until feeling
depressed to cause stress in some pregnant women
(Kang et al., 2016). Pregnant women with trimester
3 the number of sleep disorders is higher because of
discomfort such as low back pain, urinating a lot so
that spontaneously awakening from sleep. Fetal
movements cause heartburn, cramps in the legs,
fatigue and difficulty starting sleep or difficulty
sleeping until morning. (Grace, 2003)
This is in line with this study that pregnant women
with trimester 3 tend to be at risk of stress. This is
also related to the theory of anxiety, fear, anxiety,
stress that arises and is sometimes influenced by
pathophysiological conditions that arise due to
pregnancy and psychologically suggested changes in
responsibility to parents, childbirth will be faced up
to the concerns of the economy in children. (Zanto et
al., 2011)
4.4 Levels of Stress with Work for Pregnant
Women at PuskesmasPlaju Palembang
Based on the statistical test results obtained
p-value of 0.001 (p-value <0.05) which means there
is a relationship between work and stress levels in
pregnant women at the Plaju Health Center in
Palembang. The value of the Prevalence Ratio (PR)
shows the number 2.914 means that pregnant
women who work at risk are 2,914 times higher to
experience stress than pregnant women who do not
work (95% CI = 1,511-5,620). In the population it is
believed that 95% of working pregnant women are
at risk of experiencing stress compared to non-
Advances in Health Sciences Research, volume 25
73
working pregnant women with a range of 1,511 to
5,620.
The data of this study found 86 pregnant women
(55.1%) of whom 42 employees included: 10 private
employees, 2 bank employees, 4 Pertamina
employees, 7 lecturers, 7 teachers, 2 policewomen,
PNS 4 people, 3 nurses, SPG 3 people. While 44
entrepreneurs include: 3 people washing workers, 1
person souvenir craftsman, 1 person handlers, 39
traders. and 70 (44.9%) non-working pregnant
women in the Palembang public health clinic.
This is in line with research (Syahitdah, Rohmah and
Nissa, 2017). There is a significant relationship
between work and stress, due to the type and
duration of work affecting stress and blood pressure.
The effects of stress due to work will stimulate the
adrenal glands to secrete the hormone adrenaline
which can trigger heart rate faster. The impact is an
increase in blood pressure. In this study also showed
that there were 59 (68.6%) pregnant women who
worked experiencing stress.
Other research, namely research (iskandar,
2019)states that shows that there is a relationship
between workload and pregnancy steressor.
Characteristics of work can be a stressor including
work or physical activity in managing the
household, work that requires a long standing of
more than 6 hours / day, working hours more than
42 hours per week, mothers who work all the time
can cause physical and psychological pressure so
that it can cause stress to depression so that it
contributes to complications during pregnancy.
Because of the nature of pregnant women at work
while not in a state of pregnancy with pregnant
women who work in conditions of pregnancy has
given a pathological and psychosocial burden on
pregnant women.
4.5 Stress Levels with Household Income for
Pregnant Women at PuskesmasPlaju Palembang
In this study, the statistical test results obtained p-
value of 0.018 (p-value <0.05) which means there is
a relationship between income and stress levels in
pregnant women at the Plaju Health Center in
Palembang. The value of Prevalence Ratio (PR)
shows 2,173 meaning that pregnant women who
have an income <UMR are 1,433 times higher risk
of experiencing stress than pregnant women who
have an income> UMR (95% CI = 1,136-4,156).
The population is believed to be 95% that pregnant
women who have an income <UMR are at risk of
experiencing stress compared to pregnant women
who have an income> UMR with a range of 1.136 to
4.156.
Data Details of the research results obtained
household income of pregnant women <UMR 89
(57.1%), household income of pregnant women>
UMR 67 (42.9%) household income of pregnant
women <UMR more than household income that >
UMR because more pregnant women who do not
work compared to pregnant women who work, in
pregnant women who do not work get some
income> UMR this is caused by the income of her
husband who is indeed> UMR, while pregnant
women who work do get also some whose income is
<UMR although it has been added to their husband's
income. The UMR of Palembang City is Rp.
2,804,453.
These results are in line with research (Sophia,
2019) in the Journal of Averrous Vol.5 No.1 that
concerns about financial problems have a very
significant relationship with complications in
pregnant women who are affected by stressful
conditions. Pregnant women who experience stress
due to financial or income concerns in the study in
Advances in Health Sciences Research, volume 25
74
the North Aceh working area reach 4,282 times the
risk of pregnancy complications. Stress during
pregnancy is closely related to the occurrence of
premature labor that is at risk of depression until
after delivery. Stress in pregnant women is very
complex, one of which is economic factors.
Economic factors are a supporting factor rather than
the survival of one's life.
This is related to the fact that at the time of the study
it was found that some pregnant women were
concerned about the issue of childbirth funds which
at this time were not cheap because they did not use
health insurance to finance other children in terms of
food, housing and tertiary. Competitive modern life
would lead to conditions of economic hardship so
that it can trigger chronic stress, if not overcome by
coping or the right way will interfere with
homeostasisin controlling cortisol levels. This can
also be influenced by how pregnant women deal
with stress because each pregnant woman is also
different in dealing with their stress.
4.6 Stress Level with Parity Status in Pregnant
Women at PuskesmasPlaju Palembang
This study obtained statistical test results
obtained a p-value of 0.489 (p-value> 0.05) which
means there is no relationship between parity and
stress levels in pregnant women at the Plaju Health
Center in Palembang. With detailed data on parity
status or the number of children in pregnant women
it is found that there are more than 1 children
(multipara) as many as 56 (35.9%), while pregnant
women who have their first child (primipara) as
many as 100 (64.5%). With multiparous pregnant
women experiencing stress is 34 (60.7%).The results
in this study are in line with research (Sembiring
2018) that parity status has a significant relationship
to the risk of stress in pregnant women and the risk
of developing pre-eclampsia. This research shows
that stress is influenced by the condition of fear,
anxiety caused by giving birth to the first child and
fear of death during labor. This supports 80% of all
cases of pregnancy complications (3-8%) occurring
in primiparous parity status.
4.7 Stress Level with a History of Disease in
Pregnant Women at PuskesmasPlaju Palembang
Statistical test results obtained a p-value of
0,000 (p-value> 0.05) which means there is a
relationship between the history of the disease and
the stress level in pregnant women at the Plaju
Health Center in Palembang. The value of the
Prevalence Ratio (PR) shows the number 4.581
means that pregnant women who have a history of
chronic disease are 4.581 times higher risk of
experiencing stress than pregnant women who have
no history of chronic disease (95% CI = 1.870-
11.224). The population is believed to be 95% that
pregnant women who have a history of chronic
disease are at risk of experiencing stress compared
to pregnant women who have no history of chronic
diseases with a range of 1,870 to 11,224.
With detailed data based on the results of the history
of the disease obtained by pregnant women who
have a history of chronic disease as many as 38
(24.4%). The diseases obtained in this study were 5
people with asthma, 18 people with hypertension, 13
people with Maagh, 2 people with diabetes mellitus,
while mothers there were 118 (75.6%) pregnant
women with no chronic chronic disease at the Plaju
Palembang Public Health Center.
This is in line with research (Sembiring, 2018) that
pregnant women who have mild stress have a
tendency to experience hypertension 4 times
compared to non stressed pregnant women. Stress-
related steroid resistance can disrupt the
Advances in Health Sciences Research, volume 25
75
hypothalamus-pituitary-adrenal axis thereby
increasing the uterine artery resistance index.
Increased oxygen demand in the body will increase
arterial pressure and heart frequency so that
peripheral blood vessels experience
vasoconstriction, an increase in blood pressure in
pregnant women (Sembiring et al., 2018)(Asthma is
a disease that often provides significant medical
complications in pregnancy. About 4-8% of
pregnancies have asthma complications. The
prevalence of asthma morbidity continues to
increase from year to year even though the mortality
rate has decreased. The severity of asthma in
patients during pregnancy is often exacerbated by
the risk factor for asthma, stress, so patients need
asthma medications used (Folkman, S., & Lazarus,
1985)
Diabetes Militus or commonly referred to as
diabetes during normal pregnancy, women
experience short insulin resistance and glycemia
after eating. Increased sugar consumption in
pregnant women causes hyperglycemia. But in
pregnant women with a history of type 2 diabetes
mellitus the risk of pre-eclampsia is 4 times higher
than for pregnant women without a history of
diabetes mellitus.
Based on the conditions in this study pregnant
women who have a medical history record tend to
have stress due to anxiety, fear and anxiety at the
time of the condition every day,the condition at the
time of labor took place until it was very worried
about the condition of the fetus it was
carrying.Assuming each mother's mind whether
there is no problem they consume these drugs for the
fetus.
4.8 Stress Levels with Pregnancy Exercise in
Pregnant Women at PuskesmasPlaju Palembang
Statistical test results obtained a p-value of
0.760 (p-value> 0.05) which means there is no
relationship between pregnancy exercise with stress
levels in pregnant women at the Plaju Health Center
in Palembang. Details of the data based on the
results of research in the Public Health Center in
Plaju found that more pregnant women who did not
take part in the exercise were 141 people (90.4%)
while 15 women (9.6%) participated in the
exercises. This is related to the lack of socialization
of pregnancy exercises held by puskesmas and the
lack of activeness of pregnant women regarding the
importance of pregnancy exercises.
Pregnancy exercise is a form of exercise or
structured exercise. Exercise has the benefits of
reducing stress during pregnancy, increasing fetal
and placental growth in the first and second
trimester, reducing the incidence of complications in
pregnancy, easing labor, reducing back pain,
enhancing physical and psychological health,
providing comfort or relaxation, and mastering
techniques in breathing from pregnancy to childbirth
(iskandar, 2019)(Wahyuni, 2013)
But in the study it was found that pregnant women
who followed gymnastics but remained stressed
there were 8 people (53.3%) this was due to the fact
that pregnant women had participated in gymnastics
but only occasionally and not routinely so that it did
not have a comprehensive effect for the pregnant
women. Sometimes delays in information obtained
by pregnant women so that they do not follow the
gymnastic agenda, coupled with in this study many
respondents of pregnant women who work so that
the lack of time to attend gymnastics is reduced
because of the tight work schedule. In the data of
pregnant women who are gymnastic and not
stressed, there are 7 people (46.7%) of these mothers
Advances in Health Sciences Research, volume 25
76
who have been doing routine exercises and other
sports.
There are some who do have a pregnancy exercise
community at the nearest clinic from their home. So
that the effects of routine exercise done by pregnant
women have an impact on the reduction of
complaints during pregnancy, including stress not
indicated.
The majority of data on pregnancy exercises for
pregnant women in this study are pregnant women
who do not exercise and indicated stress as many as
82 people (58.2%) according to Whulandari (2006)
that this exercise is an effective prenatal service to
reduce the anxiety of pregnant women in facing
constraints when pregnancy so that there should be
differences in pregnant women who follow
gymnastics and pregnant women who do not follow
gymnastics on the stress level of pregnant women.
But in this study it was given that 59 people (41.8%)
did not follow gymnastics and they were not
indicated stressed. This explains that the obstacles
during pregnancy for each pregnant woman are
different as well as stress control during pregnancy
for each pregnant woman.
4.9 Multivariate Analysis
Multivariate analysis was carried out to determine
which independent variables had the greatest
influence on the dependent variable of the analysis
used was a multiple logistic regression test. The
analysis used in this study is multiple logistic
regression with the Backward LR method.This
multivariate analysis is a follow-up to the bivariate
test. Statistically significant variables (p <0.05), and
having p values <0.25 included in the analysis
process. Based on table 4.21 we get a logistical
equation model for predicting stress events in
pregnant women:
The equation model explains that the incidence
of stress in pregnant women is influenced together
by factors of gestational age, occupation, history of
illness, total physical activity.
Model Prediction / Probability of Bound Variables.
To determine the probability of stress occurring in
pregnant women, the formula used is:
Information
P = probability for stress to occur
e = natural number = 2.7
y = constant + a1x1 + a1x2 + ... ..aixi
a = coefficient value of each variable
x = value of the free variable
The probability of stress occurrence in pregnant
women at the Plaju Palembang Public Health Center
is:
y = -0,928 + 0,920 (Age of Pregnancy) + 0,786
(Occupational) + 1,141 (History of Disease) + 0,706
(Total Physical Activity)
y = -0,928 + 0,920 (1) + 0,786 (1) + 1,141 (1) +
0,706 (1)
y = 1,484
The results of calculating the probability of a
stressful event if you have the risk factors above are:
p = 1 / (1 + e-y) = 1 / (1 + 2.7- (1,484))
p = 0,814
p = 81,4%
Based on the above calculation, the probability of a
pregnant woman in Plaju Palembang Public Health
Center experiencing stress is 81.4 percent if she has
a trimester of 3 gestational age, works, has a history
Occurrence of Stress = -0,928 + 0,920 (Age
of Pregnancy) + 0,786 (Occupation) + 1,141
(History of Disease) + 0,706 (Total Physical
Activity)
P= 1/(1+e-y)
Advances in Health Sciences Research, volume 25
77
of chronic illness, has excessive total physical
activity.
5. CONCLUSION
The results of the analysis of Physical Activity
Against Stress Levels in Pregnant Women in
PuskesmasPlaju Palembang:
- 1. Factors that influence the level of stress in
pregnant women in the work area of Plaju
Palembang Health Center are total physical
activity, age of pregnant women, gestational age,
level of education, type of work, total income,
parity status, pregnancy exercise and history of
illness.
2. The results of the analysis of the relationship
between physical activity and stress levels are
- There is a significant relationship between total
physical activity, gestational age, occupation,
income and history of illness to stress levels in
pregnant women at the PuskesmasPlaju
Palembang
- There is no significant relationship between the
age of pregnant women, parity status and
pregnancy exercise on the level of stress in
pregnant women at the PuskesmasPlaju Palembang
3 Factors that most influence the level of stress in
pregnant women at the Plaju Palembang Health
Center are total physical activity, gestational age,
occupation, and history of the disease.
ETHICAL APPROVAL
This research was conducted after obtaining
approval from the Health Research Ethics
Committee of the Faculty of Public Health,
Sriwijaya University. The aim is to ensure that
the research proposed is ethically acceptable
and that the welfare and rights of research
participants are protected.
REFERENCES
Annemarie Hennessy, S. Ananth Karumanchi,
M. (2017) Pregnancy Hypertension: An
International Journal of Women’s Cardiovascular
Health. Available at:
www.journals.elsevier.com/pregnancy-
hypertension/%0D.
Bobak, L. (2014) Keperawatan Maternitas.
Edited by EGC. Jakarta.
Bruce, M. (1998) ‘Stress, Adaptation, and
Disease: Allostasis and Allostatic Load’, The New
York Academy For Science. Available at:
https://nyaspubs.onlinelibrary.wiley.com/doi/abs/10.
1111/j.1749-
6632.1998.tb09546.x?sid=nlm%3Apubmed.
Folkman, S., & Lazarus, R. S. (1985) ‘f it
changes it must be a process: Study of emotion and
coping during three stages of a college
examination.’, Journal of Personality and Social
Psychology, 48(1), pp. 150170. Available at:
https://psycnet.apa.org/record/1985-18642-001.
Grace, S. (2003) ‘The effect of postpartum
depression on child cognitive development and
behavior: A review and critical analysis of the
literature’, Achievy Mental Health.
Guiton (2008) Buku Ajar Fisiologi Kedokteran.
Jakarta.
Idalia Garza Veloz (2017) ‘Maternal distress and
the development of hypertensive disorders of
pregnancy’, Journal of Obstetrics and Gynaecology.
iskandar (2019) ‘CONTRIBUTION
INDICATORS OF WORK STRESS AND
EMPLOYEE ORGANIZATIONAL
COMMITMENTS CASE STUDY’, mental health.
Kang, Y. T. et al. (2016) ‘Prevalence and risk
factors of maternal anxiety in late pregnancy in
China’, International Journal of Environmental
Research and Public Health, 13(5). doi:
10.3390/ijerph13050468.
Kemenkes (2015) ‘Profil Kesehatan Tahun
2014’. Jakarta.
Kordi, M. et al. (2017) ‘Anxiety during
pregnancy and preeclampsia: a case - control study’,
Journal of Midwifery & Reproductive Health, 5(1),
pp. 814820. doi: 10.22038/jmrh.2016.7881.
kristyanasari (2010) Gizi Ibu Hamil. Jakarta:
Nuha Medika.
Lobel & Dunkel Schetter, 2016 (2016)
Advances in Health Sciences Research, volume 25
78
‘Pregnancy and Prenatal Stress’, FXCM. Available
at:
https://www.researchgate.net/publication/301928603
_Pregnancy_and_Prenatal_Stress.
marmi (2012) Asuhan Kebidanan Pada Ibu
Hamil edisi 7. Edited by pelajar. yogyakarta.
Ml, V. (2019) ‘Modeling Patterns of
Polyvictimiztion and Their Associations with
Posttraumatic Stress Disorder and Complex
Posttraumatic Stress Disorder in the Israeli
Population’, NCBI. Available at:
https://www.ncbi.nlm.nih.gov/pubmed/31661573.
prawihardjo (2008) Ilmu Kebidanan. Edited by
EGC.
Profil Kesehatan Indonesia (2017) ‘Angka
Kematian Ibu’. Indonesia.
Profil Kesehatan Palembang (2017) ‘Profil
Kesehatan Palembang’.
Qiu, J. L. et al. (2008) ‘Arabidopsis mitogen-
activated protein kinase kinases MKK1 and MKK2
have overlapping functions in defense signaling
mediated by MEKK1, MPK4, and MKS1’, Plant
Physiology, 148(1), pp. 212222. doi:
10.1104/pp.108.120006.
Riset Kesehatan Dasar (2018) ‘Rencana
Pembangunan Jangka Menengah Nasional’. Jakarta.
Sembiring, R. L. et al. (2018) ‘Pregnancy
Induced Hypertension Accompanied With Anemia:
Potential Stunting of Newborns’, Global Journal of
Health Science, 10(6), p. 164. doi:
10.5539/gjhs.v10n6p164.
Syahitdah, Rohmah and Nissa, C. (2017)
‘HUBUNGAN ANTARA AKTIVITAS FISIK DAN
STRESS DENGAN TEKANAN DARAH PADA
WANITA PREDIABETES USIA 35-50 TAHUN DI
SEMARANG’, Universitas Diponogoro. Available
at: https://ejournal.undip.ac.id/index.php/jgi/.
Zanto, T. P. et al. (2011) ‘NIH Public Access’,
46(4), pp. 564574. doi:
10.1016/j.cortex.2009.08.003.Predictive.
Advances in Health Sciences Research, volume 25
79
... Feelings of restlessness, anxiety and discomfort in pregnant women can result from excessive activities (Yusmutia et al., 2020). Stress in pregnant women can be one of the causes of hypertension. ...
Article
Full-text available
Introduction many expectant mothers are unaware of the best physical activities to engage in to reduce stressful situations. Stress situations have an impact on pregnant women's and unborn children's health. Purpose of this study was to examine the connection between pregnant women's levels of physical activity and stress in the Banguntapan 1 Public Health Center workplace. Methodology this study employed a cross-sectional study design and a quantitative methodology. At Banguntapan Health Center 1, a purposive sampling was conducted on 78 pregnant women. Findings according to the study's findings, there was no correlation between pregnant women's levels of stress and physical activity (p value = 0.296). Implication the majority of pregnant women had heavy physical activity because most pregnant women carried out daily activities such as before pregnancy such as carrying out daily activities such as before pregnancy and were still actively working or selling to meet their daily needs.
Article
Full-text available
Despite the implementation of programmes to improve maternal health, maternal and foetal mortality rates still remain high. The presence of maternal distress and its association with the development of pregnancy hypertensive disorders is not well established. The aim of this study was to evaluate the association between maternal distress and the development of hypertensive disorders in pregnancy in a prospective cohort of 321 Mexican women. Symptoms of maternal distressing were evaluated at week 20th of gestation using the General Health Questionnaire. The presence of acute somatic symptoms, social dysfunction, anxiety and insomnia increased the odds of developing a pregnancy hypertensive disorder by 5.1–26.4 times in study population (p values < .05). Our results support the participation of maternal distress in the development of hypertensive disorders of pregnancy. The implementation of effective programmes prioritising risk factors during pregnancy including the presence of maternal distressing factors is recommended. • Impact statement • What is already known on this subject: Changes in the nervous, endocrine, and immune systems have been observed in pregnant women with distress conditions leading to gestational disorders. • What do the results of this study add: The presence of acute somatic symptoms, social dysfunction, anxiety and insomnia increased the developing of hypertensive disorders in Mexican population. • What are the implications of these findings for clinical practice and/or further research: These findings may contribute to a better understanding of the role of the maternal stress in the development of hypertensive disorders of pregnancy, and in the implementation of effective programmes for clinical practice prioritising risk factors during pregnancy, including the presence of maternal distressing factors.
Article
Full-text available
108 undergraduates completed a stress questionnaire in class 2 days before the midterm, 5 days after the midterm and 2 days before grades were announced, and 5 days after grades were announced. Results show that for Ss as a whole, there were significant changes in emotions and coping (including the use of social support) across the 3 stages. Some Ss experienced seemingly contradictory emotions and states of mind during every stage of the encounter; Ss experienced both threat emotions and challenge emotions, reflecting ambiguity regarding the multifaceted nature of the examination and its meanings (especially during the anticipatory stage). Ss used combinations of most of the available forms of problem-focused coping and emotion-focused coping at every stage. Problem-focused coping was more prominent in the anticipatory stage and distancing more prominent during the waiting stage. An analysis of selected appraisal and coping values, taking GPAs into account, explained about 48% of variance in threat and challenge emotions at the anticipatory stage. Including grade, 57% of the variance in positive emotions at outcome and 61% of negative emotions at outcome were explained. (49 ref)
Article
Full-text available
The incidence of postpartum depression (PPD) in Western societies is approximately 10-15% and its cause multi-faceted. Because mothers largely constitute infants' social environment and mediate their experience of the external world, it is imperative to investigate the effects of PPD on child growth and development. PsycInfo, Medline, Embase, CINAHL, ProQuest, and Health Star databases were searched with key terms for English language abstracts from 1990 onwards, and key contents were searched. There are small effects of PPD on cognitive development such as language and IQ, seen particularly among boys. Behavioral effects are variably supported, but may persist up to 5 years postpartum and beyond. However, chronic or recurrent maternal depression, rather than postpartum depression per se is likely related to later effects on the child. These adverse effects of PPD based on sex of infant are discussed.
Article
Full-text available
The Arabidopsis (Arabidopsis thaliana) MKK1 and MKK2 mitogen-activated protein kinase kinases have been implicated in biotic and abiotic stress responses as part of a signaling cascade including MEKK1 and MPK4. Here, the double loss-of-function mutant (mkk1/2) of MKK1 and MKK2 is shown to have marked phenotypes in development and disease resistance similar to those of the single mekk1 and mpk4 mutants. Because mkk1 or mkk2 single mutants appear wild type, basal levels of MPK4 activity are not impaired in them, and MKK1 and MKK2 are in part functionally redundant in unchallenged plants. These findings are confirmed and extended by biochemical and molecular analyses implicating the kinases in jasmonate- and salicylate-dependent defense responses, mediated in part via the MPK4 substrate MKS1. In addition, transcriptome analyses delineate overlapping and specific effects of the kinases on global gene expression patterns demonstrating both redundant and unique functions for MKK1 and MKK2.
Stress, Adaptation, and Disease: Allostasis and Allostatic Load', The New York Academy For Science
  • Annemarie Hennessy
  • S Ananth Karumanchi
  • M Bobak
Annemarie Hennessy, S. Ananth Karumanchi, M. (2017) Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health. Available at: www.journals.elsevier.com/pregnancyhypertension/%0D. Bobak, L. (2014) Keperawatan Maternitas. Edited by EGC. Jakarta. Bruce, M. (1998) 'Stress, Adaptation, and Disease: Allostasis and Allostatic Load', The New York Academy For Science. Available at: https://nyaspubs.onlinelibrary.wiley.com/doi/abs/10. 1111/j.1749-6632.1998.tb09546.x?sid=nlm%3Apubmed.
Prevalence and risk factors of maternal anxiety in late pregnancy in China
  • Y T Kang
Kang, Y. T. et al. (2016) 'Prevalence and risk factors of maternal anxiety in late pregnancy in China', International Journal of Environmental Research and Public Health, 13(5). doi: 10.3390/ijerph13050468. Kemenkes (2015) 'Profil Kesehatan Tahun 2014'. Jakarta. Kordi, M. et al. (2017) 'Anxiety during pregnancy and preeclampsia: a case -control study', Journal of Midwifery & Reproductive Health, 5(1), pp. 814-820. doi: 10.22038/jmrh.2016.7881. kristyanasari (2010) Gizi Ibu Hamil. Jakarta: Nuha Medika.
Modeling Patterns of Polyvictimiztion and Their Associations with Posttraumatic Stress Disorder and Complex Posttraumatic Stress Disorder in the Israeli Population
Advances in Health Sciences Research, volume 25 'Pregnancy and Prenatal Stress', FXCM. Available at: https://www.researchgate.net/publication/301928603 _Pregnancy_and_Prenatal_Stress. marmi (2012) Asuhan Kebidanan Pada Ibu Hamil edisi 7. Edited by pelajar. yogyakarta. Ml, V. (2019) 'Modeling Patterns of Polyvictimiztion and Their Associations with Posttraumatic Stress Disorder and Complex Posttraumatic Stress Disorder in the Israeli Population', NCBI. Available at: https://www.ncbi.nlm.nih.gov/pubmed/31661573. prawihardjo (2008) Ilmu Kebidanan. Edited by EGC. Profil Kesehatan Indonesia (2017) 'Angka Kematian Ibu'. Indonesia. Profil Kesehatan Palembang (2017) 'Profil Kesehatan Palembang'.
Pregnancy Induced Hypertension Accompanied With Anemia: Potential Stunting of Newborns
  • Pembangunan Jangka Menengah Nasional
  • Jakarta
  • R L Sembiring
Pembangunan Jangka Menengah Nasional'. Jakarta. Sembiring, R. L. et al. (2018) 'Pregnancy Induced Hypertension Accompanied With Anemia: Potential Stunting of Newborns', Global Journal of Health Science, 10(6), p. 164. doi: 10.5539/gjhs.v10n6p164. Syahitdah, Rohmah and Nissa, C. (2017) 'HUBUNGAN ANTARA AKTIVITAS FISIK DAN STRESS DENGAN TEKANAN DARAH PADA WANITA PREDIABETES USIA 35-50 TAHUN DI SEMARANG', Universitas Diponogoro. Available at: https://ejournal.undip.ac.id/index.php/jgi/.