Peer-reviewed article
Core Symptoms and Candidate Targets for Symptom Management in Late Pregnancy: A Network Analysis.
Zhang X, Zhao Y, Yang J, Xu J, Jiang P et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined symptom patterns in pregnant women in late pregnancy using network analysis to identify which symptoms are most interconnected and might be priority targets for intervention. Researchers surveyed 444 pregnant women and found six clusters of symptoms including sleep problems, emotional symptoms, and gastrointestinal issues. The analysis identified fatigue, chest tightness, and anxiety as core symptoms that might be good targets for managing overall symptom burden during pregnancy.
Key points
- Six symptom clusters were identified in late pregnancy: sleep and physical discomfort, cardiopulmonary load-related, emotional, gastrointestinal, uterine activity-related, and limb/skin
- Fatigue, chest tightness, and anxiety emerged as core symptoms with the strongest connections to other symptoms
- Computer simulations suggested that relieving shortness of breath, fatigue, and chest tightness would have the largest impact on reducing overall symptom burden
- Loss of appetite, nausea, and anxiety showed the largest simulated increases in overall symptom burden when aggravated
Limitations
This study focuses on pregnant women rather than child health or well-being, so it does not directly inform interventions or outcomes for children. The cross-sectional design cannot establish causation or predict long-term impacts on maternal or child health outcomes.
Abstract
Purpose Women in late pregnancy experience multiple co-occurring physical and psychological symptoms that may affect daily functioning and well-being. However, conventional approaches are limited in identifying priority intervention targets within complex symptom patterns. This study aimed to identify core symptoms and potential targets for symptom management using a network-based approach. Patients and methods A cross-sectional study was conducted among 444 women in late pregnancy recruited by convenience sampling from a maternal and child health hospital and a tertiary general hospital. Data were collected using a general information questionnaire and a Symptom Assessment Scale for Women in Late Pregnancy, which demonstrated good content validity and internal consistency. Symptom clusters were identified using exploratory factor analysis with principal component extraction, and a covariate-adjusted symptom network was constructed to explore inter-symptom relationships. Computer-simulated interventions were performed to examine the potential impact of symptom alleviation and aggravation within the network. Results Six symptom clusters were identified: sleep and physical discomfort, cardiopulmonary load-related, emotional, gastrointestinal, uterine activity-related, and limb/skin clusters. After controlling for covariates, the cluster-specific core symptoms were fatigue (strength = 0.93), chest tightness (strength = 1.18), anxiety (strength = 1.15), nausea (strength = 0.70), abdominal tightness (strength = 1.26), and numbness or tingling in the hands, feet, or legs (strength = -0.11). Simulation analyses suggested that, in the alleviation simulations, shortness of breath/dyspnoea, fatigue, and chest tightness were associated with the largest simulated reductions in overall symptom burden. In the aggravation simulations, loss of appetite, nausea, and anxiety showed the largest simulated increases in overall symptom burden. Conclusion This study identified key symptoms and candidate symptom targets within interconnected symptom networks in late pregnancy. The findings may provide exploratory insights for multidisciplinary healthcare professionals, including midwives and obstetricians, to better prioritise and individualise symptom assessment and management in antenatal care.