Social support, coping, and self-esteem in relation to psychosocial factors : A study of health issues and birth weight in young mothers in Tehran, Iran

Introduction: Generally, pregnancy is considered to be a positive period in life in Iranian culture. For the parents, it is important to have a healthy pregnancy and, as a result, a healthy child. A sufficient birth weight of the infant represents one of the crucial conditions of a healthy development of a child during infancy as well as later in life. Ongoing research has been carried out regarding various medical factors related to birth weight, but there is a gap in knowledge about psychosocial factors such as social support, coping, self-esteem, stress and mother’s mental health, and various socio-demographic factors including domestic violence, which may lead to adverse pregnancy outcomes such as low birth weight. This thesis aims to provide knowledge to fill this gap. Methods: A cross-sectional survey was conducted in Tehran, Iran, including 600 young mothers who had delivered in Akbarabadi hospital, one of the main gynaecological hospitals affiliated with Tehran University of Medical Sciences. The investigation included a self-developed socio-demographic form, the Social Support Questionnaire, the Ways of Coping Checklist, Rosenberg’s Self-Esteem Scale, the General Health Questionnaire-12, and a Life Event Checklist. Results: We could not find a significant association between birth weight and mother’s level of education, and there was no substantial relationship between general mental health and birth weight. Verbal abuse was reported by 26.0% of the young mothers, 4.8% reported physical abuse, 5.5% reported sexual abuse, and 1.3% reported all three types of abuse. The abuse-index was significantly negatively associated with satisfaction with social support and with self-esteem. The higher the abuse-index, by trend, the lower was the infants’ birth weight. Weight before pregnancy, current weight, weight gain during pregnancy, and the number of prenatal care visits were significantly positively associated with the weight of the newborn. Mothers who reported having a history of a low birth-weight (LBW) child or were physically abused during pregnancy had infants with significant lower birth weight. The more the pregnant women were satisfied with their social support and the more often they used positive reappraisal as a way of coping, the higher was their infants’ birth weight. The higher the self-esteem, the less often they used escape avoidance and confrontive coping. Conclusion: The results suggest the importance of relationships between a healthy pregnancy and psychosocial as well as socio-demographic factors. Providing pregnant women with social support is a key component for a healthy pregnancy, especially when faced with stressful situations. The number of people available for support did not provide a significant buffering effect on domestic violence (DV), but the perceived quality of social support did. Higher education in the mother and husband, and women’s employment represented protective conditions against the occurrence of DV. Women who reported physical abuse during pregnancy had infants with lower birth weight. Satisfaction with social support and use of positive reappraisal were significantly associated with higher birth weight