Symptom Experience in Late Pregnancy

Objective: To evaluate the frequency, severity, distress, and correlates of common and rare symptoms reported by nulliparous women during the last month of pregnancy. Design: Secondary cross-sectional analysis of data obtained in a larger randomized clinical trial. Setting: San Francisco Bay area. Participants: Nulliparous, ethnically diverse, predominantly low-income pregnant women 18 to 47 years of age (N = 151). Methods: Participants at or beyond 36 weeks gestation used the Memorial Symptom Assessment Scale (MSAS) to provide self-reports of general symptom experience. Other symptom measures were also completed for comparison. Demographic characteristics, including gestational weight gain, were also collected. Gestational weight gain was categorized in relation to the Institute of Medicine's 2009 recommendations for weight gain during pregnancy. Results: Women endorsed an average of 10.6 +/- 5.6 symptoms on the MSAS. Prevalent symptoms (reported by at least half the sample) included lack of energy, pain, difficulty sleeping, worrying, irritability, drowsiness, shortness of breath, and nervousness. Among the women who reported these symptoms, relatively few described them as occurring with high frequency or severity or as causing much distress. One of the most prevalent symptoms (reported by 68% of women) was difficulty sleeping, which also had among the greatest ratings for frequency, severity, and distress. Although few maternal characteristics were associated with symptom experience, women who gained more weight than the Institute of Medicine's recommendation had worse MSAS total scores than women who gained the recommended amount or less. Conclusion: In nulliparas, symptom frequency, severity, and distress varied and were related to excessive gestational weight gain.