The relationship of depression, anxiety, and stress with pregnancy symptoms and coping styles in pregnant women: A multi-group structural equation modeling analysis

Background: The changes during pregnancy can increase susceptibility to mental health problems such as depression, anxiety and stress, which is why coping strategies are so important. The aim of this study is to investigate the relationships between depression, anxiety, stress, pregnancy symptoms and coping styles in pregnant women across trimesters, using a multigroup structural equation model. Methods: This cross-sectional and correlational study was conducted with 301 pregnant women who applied to the prenatal clinic of a state university's medical faculty. A hypothetical model was created based on transactional stress and coping theory and literature reviews. Data were collected using a participant information form, the Depression Anxiety Stress Scale, the Pregnancy Symptom Inventory and the Stress Coping Styles Scale. Results: Among pregnant women, 40.9 % had symptoms of stress, 52.8 % of anxiety and 37.2 % of depression. Pregnancy symptoms and emotion-focused coping are positively associated with depression, anxiety, and stress (beta = 0.468-0.590; beta = 0.222-0.373 respectively). Problem-focused coping is negatively associated with depression, anxiety, and stress. (beta = -0.255:-0.389). Problem-focused coping is negatively associated with pregnancy symptoms in the whole sample (beta = -0.121) and in the third trimester (beta = -0.124). The model explained 51 % of the variance in the 1st, 42 % in the 2nd, and 64 % in the 3rd trimesters. Conclusion: This study showed that problem-focused coping strategies are negatively associated with depression, anxiety and stress and play an important protective role in this context. These findings contribute to understanding the factors affecting mental health during pregnancy and emphasize the importance of developing problem-focused coping skills for pregnant women.