Abstract:

Objective: To explore the relationship among pregnancy stress, psychological resilience and coping styles in patients with non-criteria obstetric antiphospholipid syndrome (NCOAPS), and to analyze the mediating effect of coping styles between psychological resilience and pregnancy stress. Methods: From September 2022 to September 2025, the NCOAPS patients admitted to our hospital were selected for investigation by convenience sampling method. The general information questionnaire, pregnancy pressure scale (PPS), connor-davidson resilience scale (CD-RISC), and simplified coping style questionnaire (SCSQ) were used to investigate. The relationship among pregnancy stress, psychological resilience, and coping styles in NCOAPS patients was analyzed. Results: Pearson correlation analysis showed that pregnancy stress in NCOAPS patients was negatively correlated with psychological resilience (r=-0.624, P<0.001), positively correlated with negative coping (r=0.538, P<0.001), and negatively correlated with positive coping (r=-0.487, P<0.001); and that psychological resilience was negatively correlated with negative coping (r=-0.512, P<0.001) and positively correlated with positive coping (r=0.596, P<0.001). Mediation analysis showed that the direct effect of psychological resilience on pregnancy stress in NCOAPS patients was significant, with an effect value of -0.489 (95%CI: -0.628--0.350), accounting for 68.39% of the total effect. Negative coping and positive coping had partial mediating effects between psychological resilience and pregnancy stress, with mediating effect values of -0.130 (95%CI: -0.209--0.079) and -0.096 (95%CI: -0.163--0.042), accounting for 18.18% and 13.43% of the total effect, respectively. The total indirect effect was -0.226 (95%CI: -0.312--0.119), accounting for 31.61% of the total effect. Effect size evaluation showed that there were large effect correlations between psychological resilience and pregnancy stress, positive coping, and negative coping (r≥0.50). Mediation analysis indicated that the individual mediating effects of negative coping (standardized effect= -0.164) and positive coping (standardized effect=-0.123) both reached medium levels, and the total indirect effect (standardized effect=-0.287) reached a large effect level. Regression model effect size evaluation showed that the predictive effect of psychological resilience on pregnancy stress was large (f ²=0.637, explaining 38.90% of variance). After controlling the psychological resilience, the incremental contribution of negative coping was a medium effect (f ²=0.232, incremental variance explained=14.20%), and the incremental contribution of positive coping was a small effect (f ²=0.091, incremental variance explained=5.60%). Conclusions: Pregnancy stress, psychological resilience, and coping styles are closely related in NCOAPS patients. Psychological resilience can directly affect pregnancy stress, and can also indirectly affect pregnancy stress through the mediating effects of positive and negative coping. Clinically, pregnancy stress can be alleviated by enhancing patients' psychological resilience and positive coping abilities, and reducing negative coping.

Key words: Stress, psychological, Mental resilience, Coping styles, Mediating effect, Non-criteria obstetric antiphospholipid syndrome, Pregnancy stress