Latar belakang: Berat lahir bayi merupakan indikator penting status kesehatan ibu dan outcome kehamilan. Salah satu faktor yang berpotensi memengaruhi berat lahir adalah stres psikososial ibu selama kehamilan, baik secara subjektif maupun biologis. Namun, sebagian besar penelitian sebelumnya hanya mengukur stres pada satu titik waktu dan belum mengintegrasikan pengukuran psikososial dan biomarker kortisol secara longitudinal.
Tujuan: Penelitian ini bertujuan untuk menganalisis hubungan dinamika stres psikososial ibu sehat selama kehamilan terhadap berat badan lahir bayi cukup bulan.
Metode: Penelitian ini menggunakan desain kohort prospektif. Sebanyak 256 ibu hamil sehat direkrut sejak trimester pertama di lima puskesmas di Kota Makassar. Setelah mengalami drop out, tersisa 208 responden pada trimester kedua dan 178 responden pada trimester ketiga. Stres psikososial diukur menggunakan kuesioner Edinburgh Postnatal Depression Scale (EPDS) dan kadar kortisol saliva setiap trimester. Analisis bivariat dan multivariat dilakukan untuk melihat hubungan antara stress psikososial, kortisol, dan berat lahir bayi, dengan mengontrol variabel demografi, sosial ekonomi, obstetrik, nutrisi, komplikasi kehamilan, toxic eksposure, dan layanan ANC.
Hasil: Dinamika stres psikososial ibu selama kehamilan kategori stres psikososial persisten sebesar 36,52%. Stres psikososial kategori sedang hingga berat pada ibu hamil sebesar 43,26% di trimester pertama, 35,96% di trimester kedua, dan 43,82% di trimester ketiga. Kadar kortisol ibu hamil mengalami peningkatan seiring dengan bertambahnya usia kehamilan. Pada trimester pertama, kadar kortisol memiliki nilai rata-rata 7,13 ng/mL, 9,15 ng/mL pada trimester kedua dan 11,79 ng/mL pada trimester ketiga. Terdapat hubungan signifikan antara dinamika stress psikososial persisten dengan berat lahir bayi cukup bulan. Kadar kortisol juga berhubungan negatif dengan berat lahir bayi. Faktor lain yang berhubungan dengan berat lahir adalah persepsi ibu tentang dukungan suami, pertambahan berat badan selama kehamilan, hipertensi dalam kehamilan dan kelengkapan pemeriksaan ANC.
Kesimpulan: Dinamika stres psikososial persisten dan kortisol berhubungan negatif dengan berat lahir bayi cukup bulan. Temuan ini menegaskan pentingnya deteksi dini dan intervensi stres psikososial ibu hamil sebagai bagian dari pelayanan antenatal terpadu untuk mencegah BBLR.

Background: Birth weight is a key indicator of maternal health status and pregnancy outcomes. One of the potential influencing factors is maternal psychosocial stress during pregnancy, both subjectively and biologically. However, most previous studies have only measured stress at a single point and have not integrated longitudinal assessments of psychosocial stress and cortisol biomarkers.
Objective: This study aims to analyze the relationship between the dynamics of psychosocial stress in healthy pregnant women and the birth weight of term infants.
Methods: A prospective cohort design was employed. A total of 256 healthy pregnant women were recruited during the first trimester from five primary health centers in Makassar City. After accounting for dropouts, 208 participants remained in the second trimester and 178 in the third trimester. Psychosocial stress was measured using the Edinburgh Postnatal Depression Scale (EPDS) and salivary cortisol levels in each trimester. Bivariate and multivariate analyses were done to look at the relationships between psychosocial stress, cortisol, and birth weight while considering factors like demographics, income, pregnancy history, nutrition, complications, exposure to toxins, and antenatal care (ANC).
Results: Persistent psychosocial stress was found in 36.52% of participants. Moderate to severe psychosocial stress was observed in 43.26% of mothers in the first trimester, 35.96% in the second trimester, and 43.82% in the third trimester. Cortisol levels increased with advancing gestational age, from a mean of 7.13 ng/mL in the first trimester to 9.15 ng/mL in the second trimester and 11.79 ng/mL in the third trimester. A significant negative association was found between persistent psychosocial stress dynamics and birth weight. Cortisol levels were also negatively associated with birth weight. Other factors associated with birth weight included maternal perception of spousal support, gestational weight gain, hypertension, and completeness of ANC examinations.
Conclusion: Persistent psychosocial stress dynamics and cortisol are negatively associated with term birth weight. These findings highlight the importance of early detection and intervention for maternal psychosocial stress as an integral part of comprehensive antenatal care to prevent low birth weight