Psychometric properties of the Tilburg Pregnancy Distress Scale-Persian version (TPDS-P)

Background Given the importance of screening pregnant women’s distress, it was intended to investigate the psychometric properties of the Persian version of the Tilburg Pregnancy Distress Scale (TPDS-P) for screening pregnancy distress. Methods This methodological psychometric study was conducted with participation of 360 pregnant women. The TPDS was translated into Persian. Factor analysis was used to investigate the construct validity. The results of the correlation test between the results of the two questionnaires, Depression Anxiety Stress Scales-21 (DASS-21) and TPDS-P, were used to determine the criterion validity of TPDS-P. Internal consistency of the items was calculated by the Cronbach's alpha coefficient. Stability of the results was examined by test-retest method and Intra-class Correlation Coefficient (ICC) was calculated. Examining the structure of the factors derived from exploratory factor analysis, fitness of the model was done through confirmatory factor analysis. Statistical analysis was done using SPSS software. Results Kaiser-Meyer-Olkin (KMO) was 0.846 (p = 0.001). Sixteen items of TPDS-P accounted for 51.42 percent variances. The TPDS-P exhibited appropriate fitness. There was poor to moderate but significant direct correlation between the subscales of DASS-21 and TPDS-P. Cronbach’s alpha coefficient of the TPDS-P was 0.81 and ICC was 0.70. Conclusions TPDS-P, with appropriate validity and reliability, can be used as a practical scale to evaluate women's distress during pregnancy in Farsi-speaking societies.

Psychometric adequacy of the Persian adapted version of the Tilburg pregnancy distress scale (P-TPDS)

Background Pregnancy distress is a combination of anxiety, stress, and depression during pregnancy. The first step in preventing pregnancy distress is to identify women at risk. The present study assessed adaptation and psychometric adequency of the Persian Adapted Version of Tilburg Pregnancy Distress Scale (P-TPDS). Methods By Brislin’s translation guidelines, TPDS was translated to Persian. This was followed by determining the face validity of P-TPDS and evaluating construct validity using exploratory and confirmatory factor analyses. The Cronbach’s alpha coefficients and intra-class correlation coefficient (ICC) were used to estimate reliability. Results A final 16-item scale was loaded on four distinct constructs jointly accounting for 59.62% of variance. The factors were labelled as delivery-related worries, partner involvement, pregnancy-related worries, and social-related worries. The alpha coefficients for P-TPDS subscales ranged from 0.85 to 0.91 and ICC ranged from 0.70 to 0.77. All comparative indices of the model including CFI, IFI, NFI, and NNFI were above 0.9 showing the goodness of fit for the data with a RMSEA of 0.04, lower bound: 0.038. Conclusions The Persian adapted version of TPDS (P-TPDS) is a reliable and valid scale for assessing pregnancy distress among pregnant women in Iran.

Psychometric properties of the Tilburg Pregnancy Distress Scale-Persian version (TPDS-P)

Background Given the importance of screening pregnant women’s distress, it was intended to investigate the psychometric properties of the Persian version of the Tilburg Pregnancy Distress Scale (TPDS-P) for screening pregnancy distress.Methods This methodological study was conducted with participation of 360 pregnant women. The TPDS was translated into Persian. Factor analysis was used to investigate the construct validity. The results of the correlation test between the two questionnaires DASS-21 and TPDS-P were used to determine the criterion validity. Internal consistency of the items was calculated by the Cronbach's alpha coefficient. Stability of the results was examined by test-retest method. To examine the structure of the factors derived from exploratory factor analysis, fitness of the model was done through confirmatory factor analysis. Statistical analysis was done using SPSS software.Results KMO outcomes were 0.846 (p = 0.001). 16 items of TPDS-P accounted for 51.42 percent variances. The TPDS-P exhibited appropriate fitness. There was poor to moderate but significant direct correlation between the subscales of DASS-21 and TPDS-P. Cronbach’s alpha coefficient of the TPDS-P was 0.81.ICC was 0.81.Conclusion TPDS-P can be used as a scale with appropriate validity and reliability in Farsi-speaking societies to evaluate women's distress during pregnancy.

The Brabant study: design of a large prospective perinatal cohort study among pregnant women investigating obstetric outcome from a biopsychosocial perspective

BackgroundPregnancy is characterised by many biological and psychosocial changes. Adequate maternal thyroid function is important for the developing fetus throughout gestation. Latent class analyses recently showed three different patterns of change in thyroid function throughout pregnancy with different associations with obstetric outcome. Maternal distress during the pregnancy (anxiety and depression) negatively affects obstetric outcome. Pregnancy distress in turn may be affected by personality traits and attachment styles. Moreover, during the pregnancy, substantial social changes occur in the partner relationship and work experience. The aim of the Brabant study is to investigate the association between thyroid function trajectories and obstetric outcomes. Moreover, within the Brabant study, we will investigate how different trajectories of pregnancy distress are related to obstetric outcome, and the role of personality in this association. We will evaluate the possible role of maternal distress and attachment style on maternal–fetal bonding. Finally, we will study social changes in the perinatal period regarding partner relationship and well-being and performance at work.Methods and analysisThe Brabant study is a longitudinal, prospective cohort study of an anticipated 4000 pregnant women. Women will be recruited at 8–10 weeks gestation among community midwife practices in South-East Brabant in the Netherlands. Thyroid function parameters (TSH and fT4), thyroid peroxidase antibody and human chorionic gonadotrophin will be assessed at 12, 20 and 28 weeks gestation. Moreover, at these three time points women will fill out questionnaires assessing demographic and obstetric features, life style habits and psychological and social variables, such as depressive symptoms, personality, partner relationship quality and burnout. Data from the obstetric records will also be collected.Ethics and disseminationThe study has been approved by the Medical Ethical Committee of the Máxima Medical Center Veldhoven. Results will be submitted to peer-reviewed journals in the relevant fields and presented on national and international conferences.

The Brabant Study: design of a large prospective perinatal cohort study among pregnant women investigating obstetric outcome from a biopsychosocial perspective

Background: Pregnancy is characterized by many biological and psychosocial changes. Adequate maternal thyroid function is important for the developing fetus throughout gestation. Latent class analyses (LCA) (including three consecutive trimester assessments) recently showed new insights into changes of thyroid function in relation to obstetric outcome. Furthermore, maternal distress during pregnancy (anxiety and depression) negatively affects obstetric outcome. Pregnancy distress in turn may be affected by personality traits and attachment styles. Moreover, during pregnancy, substantial social changes occur in the partner relationship and work experience. The aim of the Brabant Study is to investigate the association between thyroid function trajectories and obstetric outcomes. Moreover, within the Brabant Study, we will investigate how different trajectories of pregnancy distress are related to obstetric outcome, and the role of personality in this association. We will evaluate the possible role of maternal distress and attachment style on maternal-fetal bonding. Finally, we will study social changes in the perinatal period regarding partner relationship and well-being and performance at work. Methods and analysis: The Brabant Study is a longitudinal, prospective cohort study of an anticipated 4000 pregnant women. Women will be recruited at 8-10 weeks gestation among community midwife practices in South-East Brabant in the Netherlands. Thyroid hormone levels (TSH and fT4), TPO-Ab and hCG will be assessed at 12, 20 and 28 weeks gestation. Moreover, at these three time points women will fill out questionnaires assessing demographic and obstetric features, life style habits and psychological and social variables, such as depressive symptoms, personality, partner relationship quality and burnout. Data from the obstetric records will also be collected. Ethics and dissemination: The study has been approved by the Medical Ethical Committee of the Máxima Medical Center Veldhoven. Results will be submitted to peer reviewed journals in the relevant fields and presented on national and international conferences. Strengths and limitations of this study•Prospective design with three measurements of both biological and psychological variables during pregnancy which enables the use of Latent Class Analysis;•A multi-factorial approach;•A large sample size;•Use of self-report with validated questionnaires instead of interviews.