When the distribution of socio-demographic and obstetric characteristics of pregnant women is examined, the average age of the pregnant women is 28.59 ± 6.06 years, with a minimum age of 18 and a maximum age of 43. The average weight of the pregnant women participating in the study was 71.34 ± 8.80 and the average height was 162.90 ± 4.72. It was found that 30.3% of the pregnant women have been married for 10 years or more, 59.0% have a high school education level, and 75.6% have income equal to their expenses. In obstetric data, 31.6% of the pregnant women have had three pregnancies, and 55.5% are at 28 weeks of pregnancy or above. Additionally, 39.6% of the pregnant women perceive their general health status as poor (Table 1).
According to their obstetric history, 27.9% of the pregnant women reported having had a previous operation on reproductive organs. It was determined that 21.9% have a history of preterm birth, 10.9% had a last baby birth weight of less than 2500 g, 6.5% were hospitalized due to hypertension or pre-eclampsia/eclampsia in their last pregnancy, 5.2% experienced stillbirth or neonatal loss in previous pregnancies, and 3.5% had a last baby birth weight of more than 4500 g. Regarding the current pregnancy, 39.6% of the pregnant women had a history of anemia, 21.1% experienced vaginal bleeding, 17.7% were aged 35 and over, 7.0% had diastolic blood pressure over 90 mmHg, 3.0% experienced RH incompatibility, and 2.5% reported pelvic mass issues.
In their general medical history, 40.5% of the pregnant women were found to have risky conditions detected during examination, 6.0% had other serious medical conditions, 3.0% had smoking, alcohol, or other substance dependence, and 2.7% reported thyroid disease (Table 2).
The average perceived stress scale score of the pregnant women is 83.55 ± 19.20. They received an average score of 22.52 ± 6.25 in the “Physiological Area” subscale, 29.23 ± 9.54 in the “Psychological Area” subscale, indicating a moderate level, and 31.79 ± 7.94 in the “Socio-Cultural, Developmental, and Spiritual Area,” which is a lower score below the average.
The average score for the Healthy Living Behaviors scale (LPLP) is determined to be 100.82 ± 15.84. Except for the “Physical Activity” subscale (8.39 ± 2.78), all other subscales have scores above the average. They scored close to the full score with 17.17 ± 3.16 in the “Pregnancy Responsibility” subscale, 15.76 ± 3.20 in the “Hygiene” subscale, 26.52 ± 6.11 in the “Nutrition” subscale, 16.84 ± 4.60 in the “Travel” subscale, and 16.12 ± 2.92 in the “Acceptance of Pregnancy” subscale. According to the scores obtained from the research, the perceived stress of the pregnant women is moderate, while their healthy lifestyle behaviors in pregnancy are at a high level (Table 3).
According to the statistical analysis, there is a significant difference between the age of the pregnant women and the total score of healthy living behaviors in pregnancy (F = 6.034; p < 0.000), as well as in the subscales of pregnancy responsibility (F = 6.607; p < 0.000), hygiene (F = 4.280; p < 0.002), physical activity (F = 3.134; p < 0.015), travel (F = 3.016; p < 0.018), and acceptance of pregnancy (F = 2.261; p < 0.000).
There is also a significant difference between education level and total score of healthy living behaviors in pregnancy (F = 3.469; p < 0.016) and in the subscales of pregnancy responsibility (F = 3.041; p < 0.029) and hygiene (F = 4.054; p < 0.007). Monthly income is significantly associated with pregnancy responsibility (F = 3.652; p < 0.027), hygiene (F = 4.051; p < 0.018), and nutrition (F = 2.968; p < 0.053). There are significant differences between years of marriage and total score of healthy living behaviors in pregnancy (F = 1.394; p < 0.030), pregnancy responsibility (F = 2.957; p < 0.001), nutrition (F = 2.003; p < 0.002), physical activity (F = 2.787; p < 0.001), and travel (F = 1.682; p < 0.037). Among the risky conditions, hospitalization in the last pregnancy shows significant differences with pregnancy responsibility (t = 2.480; p < 0.014) and travel (t = 2.170; p < 0.031) subscales, while last baby’s birth weight over 4500 g is significantly associated with hygiene (t = 2.413; p < 0.016). Hospitalization due to hypertension or pre-eclampsia/eclampsia in the last pregnancy also shows significant differences with pregnancy responsibility (t = 2.480; p < 0.014) and travel (t = 2.170; p < 0.031) subscales (p < 0.05) (Table 4).
Statistical analysis revealed a significant difference between age groups and perceived stress in the physiological life area sub-dimension (F = 4.216; p < 0.002). Post-hoc testing indicated that this significance was particularly noted in the 18–22 age group. According to the monthly income variable, a significant difference was found in the socio-cultural/developmental/spiritual life area perceived stress sub-dimension (F = 4.522; p < 0.011). The significance was identified between groups with income less than expenses and those with income equal to expenses. A significant difference was detected between the years of marriage and perceived stress in the physiological life area sub-dimension (F = 3.782; p < 0.011), with significance arising from those married for 7–9 years.
The presence of thyroid disease was significantly associated with the total NSMT-RGASÖ (t = 2.496; p < 0.013), perceived stress in the physiological life area (t = 2.073; p < 0.039), and perceived stress in the socio-cultural/developmental/spiritual life area (t = 2.213; p < 0.027). Significant associations were detected between the presence of other serious illnesses and perceived stress in the physiological life area (t = 3.777; p < 0.000) and the risky condition detected by examination (t = 3.358; p < 0.001). Being over 35 years was significantly associated with the socio-cultural, developmental, and spiritual area sub-dimension (t=−3.825; p < 0.000), while vaginal bleeding was significantly associated with perceived stress in the psychological life area (t = 2.589; p < 0.010). Significant associations were found between diastolic blood pressure over 90 mmHg and both the total NSMT-RGASÖ and its sub-dimensions. Specifically, the total NSMT-RGASÖ (t = 6.317; p < 0.000), perceived stress in the physiological life area (t = 6.311; p < 0.000), psychological life area (t = 5.494; p < 0.000), and socio-cultural/developmental/spiritual life area (t = 3.519; p < 0.000) showed significant associations (Table 5).
The correlation analysis revealed a low but statistically significant negative correlation between perceived stress in high-risk pregnancies and healthy lifestyle behaviors in pregnancy (r= −0.158; p < 0.001). This indicates that as the level of perceived stress decreases, healthy lifestyle behaviors in pregnancy increase. There were strong and significant negative correlations between stress and the sub-dimensions of healthy lifestyle behaviors, particularly in nutrition (r=−0.143; p < 0.001) and acceptance of pregnancy (r=−0.144; p < 0.001). A significant negative relationship was also identified with the hygiene sub-dimension (r=−0.114; p < 0.005). Furthermore, a strong positive relationship was found between healthy lifestyle behaviors in pregnancy and each sub-dimension of the scale. This indicates a strong and significant positive relationship between healthy lifestyle behaviors and the sub-dimensions of pregnancy responsibility, hygiene, nutrition, physical activity, travel, and acceptance of pregnancy (Table 6).
This table presents the regression coefficients and statistical significance of variables affecting the total score of HLSBP (Healthy Lifestyle Behaviors). Model 1 and Model 2 are presented separately with tables and interpretations.
In Model 1, only the variable “Age” is included in the model. Age significantly predicts the HLSBP score positively (B = 2.674; p = 0.001), meaning that each 1-unit increase in age corresponds to an average increase of 2.674 in the HLSB score. The standardized coefficient (Beta = 0.173) indicates a moderate effect. The VIF value is 1, indicating no multicollinearity problem.
Model 2: “Age” and “Education Level” VariablesIn Model 2, the variables “Your Age” and “Education Level” are included together. Both variables significantly predict the HLSBP score positively. The coefficient for age increased to 3.606, and its effect strengthened (p = 0.000). Education level is also a significant predictor (B = 4.250; p = 0.001). As education level increases, the HLSB score increases by an average of 4.250. The VIF values (1.149) indicate no multicollinearity problem. Age and education level are significant predictors of the HLSB score. Income level and years of marriage were excluded as they did not contribute significantly to the model.