The Effects of Individual Factors and Health Promotion During Pregnancy on Maternal-Infant Health

Abstract

The purpose of this study was to examine selected individual factors which may influence the pregnant woman's engagement in health-promotion behaviors and maternal-infant health. The theoretical framework evolved from the Health Promotion Model(Pender, 1987) and the cognitive-transactional theory of stress and coping (Lazarus & Folkman, 1984). A convenience sample of 63 low-risk and 53 high-risk pregnant women was selected for this study. The concept of high-risk in this study was narrowed to those women undergoing home uterine activity monitoring who were at risk for preterm delivery. Individual factors included self-efficacy, degree of threat, perceived social support, and perceived health status. The construct of reported health-promoting behaviors was used to describe an active approach toward improved well-being. As outcome measures of health, three concepts were used as an overall index of maternal-infant health: subjective wellbeing (positive and negative affect), maternal weight gain, and infant birth weight. Regression analyses revealed that women who reported fewer negative health symptoms and a higher number of health behaviors reported higher positive affect. The change in positive affect over time for the high-risk group reflected an increase in positive mood and social engagement. A high-risk status, high degree of threat, high perceived conflict, and a higher number of negative health symptoms were predictive of higher negative affect. Negative mood and anxiety for the high-risk group were reflected in their higher scores. The high-risk group felt greater threat from their pregnancy status, had a more negative outlook for their pregnancy, and felt less in control of the situation than did the low-risk group. While the two groups did not differ on overall reported health-promoting behaviors, the high-risk group scored significantly higher on health responsibility and lower on exercise than the low-risk group. Significant implications for nurses working with pregnant women and their families include: awareness of the need for prenatal assessment of anxiety and the meaning of the highrisk label, the need for improved risk assessment, continued education regarding expected physical and psychological changes during pregnancy, and education regarding positive health behaviors.