• Sajid Mehmood Alvi
  • Syeda Ayat-e-Zainab Ali
  • Rabia Akbar Shah
  • Tahira Jabeen
  • Nighat Gul
  • Maryam Afridi
Keywords: Depression, Anxiety, Stress, Mental wellbeing, Life satisfaction


Background: Pregnant women are at an increase risk of developing depression, anxiety and stress which can lead to less life satisfaction and decrease mental wellbeing. The present study was intended to examine the impact of internalizing psychological problems, including depression, anxiety, stress, on mental well being and life satisfaction, and to investigate depression impact on stress and anxiety among pregnant women. Method: It was a cross-sectional survey conducted at University of Haripur from Nov 2015 to May 2016. Following purposive sampling, one hundred pregnant women with age range of 19 to 38 years without any limitation of gestational age were approached during pregnancy from Obs/Gyn OPD of District Headquarter Hospital, Yahya Welfare Complex, and Allama Iqbal Hospital, Haripur. Depression, Anxiety, Stress Scale, Warwick-Edinburgh Mental Wellbeing Scale and Life Satisfaction scale were used for data collection. Pearson correlation analysis was used to access relationship among study variables. Impact of internalizing psychological problems on mental wellbeing and life satisfaction were computed through linear regression analysis. Results: Depression, anxiety and stress were positively related to each other and negatively related to wellbeing and life satisfaction (p<0.001). Linear regression analysis depicted that internalizing psychological problems have significant impact on mental wellbeing and life satisfaction (p<0.001). Further, depression has a significant impact on stress and anxiety of pregnant women (p<0.001). Conclusion: Presence of stress, depression and anxiety significantly decreases mental wellbeing and life satisfaction during pregnancy. Increase in depression is highly responsible for rise in stress and anxiety among pregnant women.


1. Pigott TA. Women’s Mental Health ―A Comprehensive Textbook. In: Kornstein SG, Clayton AH, (Eds). New York: Gulliford Press; 2002.p. 195–22.
2. Kingston D, Kehler H, Austin MP, Mughal MK, Wajid A, Vermeyden L, et al. Trajectories of maternal depressive symptoms during pregnancy and the first 12 months postpartum and child externalizing and internalizing behavior at three years. PLoS One 2018;13(4):e0195365.
3. Park S, Kim BN, Kim JW, Shin MS, Yoo HJ, Lee J, et al. Associations between maternal stress during pregnancy and offspring internalizing and externalizing problems in childhood. Int J Ment Health Syst 2014;8(1):44–8.
4. Dunkel Schetter C, Tanner L. Anxiety, depression and stress in pregnancy: Implications for mothers, children, research, and practice. Curr Opin Psychiatry 2012;25(2):141–8.
5. Marcus SM, Flynn HA, Blow FC and Barry KL. Depressive symptoms among pregnant women screened in obstetrics settings. J Women’s Health 2003;12(4):373–80.
6. Zainab S, Fatmi Z, Kazi A. Risk factors for depression among married women belonging to higher and lower socioeconomic status in Karachi, Pakistan. J Pak Med Assoc 2012;62(3):249–53.
7. Gavin NI, Gaynes BN, Lohr KN, Meltzer-Brody S, Gartlehner G, Swinson T. Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol 2005;106(5):1071–83.
8. Bergman K, Sarkar P, O’Connor TG, Modi N, Glover V. Maternal stress during pregnancy predicts cognitive ability and fearfulness in infancy. J Am Acad Child Adolesc Psychiatry 2007;46(11):1454–63.
9. Milgrom J, Gemmill AW, Bilszta JL, Hayes B, Barnett B, Brooks J, et al. Antenatal risk factors for postnatal depression: a large prospective study. J Affect Disord 2008;108(1):147–57.
10. Redshaw M, van den Akker O. Maternal mental health and wellbeing. J Reprod Infant Psychol 2007;25(4):253–4.
11. Aasheim V, Waldenstrom U, Rasmussen S, Espehaug B, Schytt E. Satisfaction with life during pregnancy and early motherhood in first-time mothers of advanced age: a population-based longitudinal study. BMC Pregnancy Childbirth 2014;14(1):86–9.
12. Hamid F, Asif A, Haider II. Study of anxiety and depression during pregnancy. Pak J Med Sci 2008;24(6):861–4.
13. Masood A, Musarrat R, Mazahir S, Naz S. Stress, anxiety and depression in women with primigravada: A study on Pakistani women. Khyber Med Univ J 2017;9(3):117–21.
14. Waqas A, Raza N, Lodhi HW, Muhammad Z, Jamal M, Rehman A. Psychosocial factors of antenatal anxiety and depression in Pakistan: Is social support a mediator? PloS One 2015;10(1):e0116510.
15. Lovibond PF. Long-term stability of depression, anxiety, and stress syndromes. J Abnorm Psychol 1998;107(3):520–6.
16. Aslam N, Tariq N. Trauma, depression, anxiety, and stress among individuals living in earthquake affected and unaffected areas. Pak J Psychol Res 2010;25(2):131–48.
17. Waqas A, Ahmad W, Haddad M, Taggart FM, Muhammad Z, Bukhari MH, et al. Measuring the well-being of health care professionals in the Punjab: a psychometric evaluation of the Warwick-Edinburgh Mental Well-being Scale in a Pakistani population. Peer J 2015;3(10):e1264.
18. Diener ED, Emmons RA, Larsen RJ, Griffin S. The satisfaction with life scale. J Pers Assess 1985;49(1):71–5.
19. Shahzad S, Riaz Z, Begum N, Khanum SJ. Urdu translation and psychometric properties of trait emotional intelligence questionnaire short-forms (TEIQue-SF). Asian J Manag Sci Educ 2014;3(1):130–40.
20. Bodecs T, Horvath B, Szilagyi E, Gonda X, Rihmer Z, Sandor J. Effects of depression, anxiety, self-esteem, and health behaviour on neonatal outcomes in a population-based Hungarian sample. Eur J Obstet Gynecol Reprod Biol 2011;154(1):45–50.
21. Omidvar S, Faramarzi M, Hajian-Tilak K, Amiri FN. Associations of psychosocial factors with pregnancy healthy life styles. PloS One 2018;13(1):e0191723.
22. Moreno-Rosset C, Arnal-Remon B, Antequera-Jurado R, Ramírez-Ucles I. Anxiety and psychological wellbeing in couples in transition to parenthood. Clinica Y Salud (Clin Health) 2016;27(1):29–35.
23. Beydoun H, Saftlas AF. Physical and mental health outcomes of prenatal maternal stress in human and animal studies: a review of recent evidence. Paediatr Perinat Epidemiol 2008;22(5):438–66.
24. O’Connor TG, Heron J, Golding J, Beveridge M, Glover V. Maternal antenatal anxiety and children’s behavioural/emotional problems at 4 years: Report from the Avon Longitudinal Study of Parents and Children. Br J Psychiatry 2002;180(6):502–8.
25. Dunkel Schetter C, Tanner L. Anxiety, depression and stress in pregnancy: implications for mothers, children, research, and practice. Curr Opin Psychiatry 2012;25(2):141–8.
26. Kessler RC, Berglund P, Demler O, Jin R, Koretz D, Merikangas KR, et al. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA 2003;289(23):3095–105.
27. Woods SM, Melville JL, Guo Y, Fan MY, Gavin A. Psychosocial stress during pregnancy. Am J Obstet Gynecol 2010;202(1):61.e1–7.


Download data is not yet available.
How to Cite
Alvi S, Ali S, Shah R, Jabeen T, Gul N, Afridi M. INTERNALIZING PSYCHOLOGICAL PROBLEMS AS PREDICTOR OF MENTAL WELLBEING AND LIFE SATISFACTION AMONG PREGNANT WOMEN. PJP [Internet]. 20Aug.2018 [cited 19Sep.2018];14(3):28-2. Available from: