An expert on prenatal stress arrives in Brno to study Czech women using a unique questionnaire

Elevated stress levels during pregnancy are a well-known risk factor. They can negatively affect the mother’s mental and physical health and also fetal growth, birth weight, and the child’s later development. The scientific community has been studying prenatal stress since the 1970s. Professor Marci Lobel, a leading global expert in this field, is spending the spring semester at the Department of Medical Psychology and Ethics at Faculty of Medicine at Masaryk University and is researching stress among Czech pregnant women.

“Earlier studies often measured stress in pregnant women based on general life stressors or anxiety, which led to inconsistent results. These approaches did not account for stressors specific to pregnancy, such as concerns about the baby’s health, childbirth, or physical changes,” explains Professor Lobel, who developed the Prenatal Distress Questionnaire (PDQ) and its revised version, the NuPDQ – an internationally recognized tool for measuring pregnancy-specific stress.

The questionnaire is both flexible and easy to use. It combines different aspects of stress, from the number of stressful events to their perceived intensity. By quantifying responses on a point scale, researchers can precisely measure how strongly pregnant women experience stress. The tool has been translated into numerous languages and used in more than a hundred studies, confirming that pregnancy-specific stress increases risk of poor birth outcomes. “Pregnancy-specific stress is concrete and immediate, which makes it particularly harmful. Our studies show that this type of stress is often a stronger contributor to adverse birth outcomes than general stress,” adds Lobel.

Studies show that stress during pregnancy originates from a combination of health-related, psychological, and social strains. How expectant mothers perceive these strains is not merely subjective – it has measurable effects on both maternal and child health. “Research has shown, for example, that first-time mothers experience 15-20% higher levels of stress than more experienced mothers. Similarly, stress levels are higher in high-risk pregnancies,” says Lobel, referring to her international study of more than 8,000 women from seven countries conducted during the COVID-19 pandemic. In this study, during lockdowns, women with limited access to outdoor spaces experienced up to 15% higher stress levels.

During her stay in Brno, Professor Lobel is adapting the NuPDQ questionnaire for the Czech context and examining how stress in pregnant women is related to other factors such as depression and positive or protective factors such as hopefulness, using a scale developed by Masaryk University Associate Professor Alena Slezáčková. The findings will provide Czech researchers and clinicians with a valuable tool to help fill gaps in the study and care of women’s health in the Czech Republic. “While doctors routinely monitor risk factors such as blood pressure and glucose levels, psychological stress is not systematically assessed during pregnancy. Being able to measure and better understand stress in pregnancy will help lay the groundwork for effective prevention and intervention strategies, ultimately improving birth outcomes,” concludes Slezáčková.