Abstract
Purpose: The aim of the study was to determine the cumulative effect of both maternal perceived stress and socioeconomic status (SES) on poor birth outcomes in a tertiary care hospital. Methods: The study was cross-sectional and was done on Benazir Bhutto Hospital, Rawalpindi during six months between January and June 2025. Consecutive sampling was used to enroll pregnant women that had 28-40 gestation (n=148). The measure of maternal stress was the 10 items Perceived Stress Scale (PSS -10) and the 3 indicators of SES (income, education, employment) were collected through structured interview. The outcome measures were preterm birth (less than 37 weeks), low birth weight (LBW; less than 2500 g), 5-minute Apgar, and admission to neonatal intensive care unit (NICU). Findings: 62.2% (92/148) and 45.3% (67/148) had moderate and high perceived stress respectively, with 62.2 and 45.3 respectively, in low-income households. Preterm birth rate was 25.7 (38/148) and LBW rate was 29.1 (43/148). The moderate-to-high stress and low stress among the women were of moderate-to-high stressed and low-stressed respectively with greater preterm birth among moderate-to-high-stressed women (34.8 vs 10.7 p=.02). LBW rates were lower in high-income households (19.8) as compared to low-income households (40.3), p= 0.01. The moderate-to-high stress (AOR 2.1; 95% CI 1.23.6) and low income (AOR 1.9; 95% CI 1.13.4) on multivariate analysis were independent predictors of preterm birth when they predicted LBW. Conclusion: It was determined that there is a positive relationship between perceived maternal stress with socioeconomic disadvantage and preterm birth concerning the low birth weight. The negative perinatal results of the vulnerable population could be reduced with the help of screening of the stress routines and certain social support.