The Maternal Adaptation Framework: A Conceptual Model of Adaptive Processes Across Pregnancy and the Great Obstetrical Syndromes.

The Great Obstetrical Syndromes (ie, preeclampsia and preterm labor) remain major contributors to maternal-fetal morbidity and mortality and are increasingly understood to involve complex, interacting pathways influenced by biological and contextual factors, rather than a single causal mechanism. A literature review revealed a lack of theoretical models capturing the multidimensional nature of pregnancy-related adaptation. Accordingly, theory-derivation methods were used to develop the Maternal Adaptation Framework as a domain-specific extension of the Roy Adaptation Model. The framework integrates contextual influences with adaptive processes to conceptualize pregnancy as a dynamic physiologic state and to guide mechanism-informed prediction, prevention, and person-centered care.