Identifying Symptom Clusters Among Pregnant Women During Early and Late Pregnancy

Objectives Symptom assessment and management among women in early and late pregnancy remains concerned, in consideration of multiple co-occurring symptoms; however, evaluation of multidimensional nature of symptom experience (e.g., frequency, severity and distress) and relevant symptom cluster among them is insufficient. To shed light on this understudied field, our study investigated the status of multiple psychosomatic symptoms among women and identified symptom clusters in different gestational stages. Methods A convenience sample of 557 pregnant women were recruited at two tertiary hospitals in Shandong, China. They were asked to complete the Memorial Symptom Assessment Scale, and sociodemographic and clinical information. Spearman correlation analysis, partial correlation networks, and hierarchical cluster analysis were carried out to identify optimal number of symptom clusters. Results Top five scores for symptoms in early pregnancy were nausea, lack of appetite, feeling drowsy, lack of energy, and vomiting; and weight gain, difficulty sleeping, sweating, lack of energy, and dry mouth scored highly in late pregnancy. Four clusters (pregnancy reaction symptom cluster, mood-fatigue symptom cluster, change in libido and food taste symptom cluster, and dry mouth-bloating symptom cluster) were identified in early pregnancy, and three clusters (mood-fatigue symptom cluster, sleep-bloating symptom cluster, and fluid deficiency symptom cluster) were determined in late pregnancy. Conclusion Women experience multiple psychosomatic symptoms during pregnancy, and the manifestation of symptoms varies in different stages. Our study has provided new insights into symptom clusters of pregnant women. These results might potentially support the development of assessment and management of multiple co-occurring symptoms in this population.