Characteristics, assessment tools, and influencing factors of symptom clusters among pregnant women in first trimester of pregnancy: a scoping review.

BACKGROUND

Early pregnancy is frequently accompanied by a confluence of somatic and psychological symptoms that aggregate into distinct symptom clusters. Evidence regarding the types, assessment tools, and influencing factors of these clusters remains fragmented. Thus, this study aims to identify the characteristics and current research status of symptom clusters experienced by pregnant women during early pregnancy, providing valuable insights for enhancing the management of symptom clusters.

METHODS

Following the Joanna Briggs Institute Scoping Review Methodology Framework and reported in accordance with Preferred Reporting Items for Systematic Review and Meta-analyses Extension for Scoping Review guidelines, we searched across eight relevant databases, including CNKI, Wanfang Data, CBM, VIP Information, PubMed, Embase, Web of Science, and CINAHL(15 March 2025). Two reviewers selected studies independently. Our research questions centered on identifying the types and characteristics of symptom clusters, available assessment tools, and the influencing factors of symptom clusters.

RESULTS

Of 18,474 records identified, a total of 12 studies were included, and 6 symptom clusters were extracted. The most prevalent were psychological-emotional, gastrointestinal and sleep-related symptoms. Ten different assessment tools were identified for evaluating symptom clusters, although there were variations among them. The most frequently used were the Memorial Symptom Assessment Scale (MSAS) and the Edinburgh Postnatal Depression Scale (EPDS). The influencing factors were primarily categorized into sociodemographic, lifestyle and behavioral and psychological factors.

CONCLUSION

Pregnant women in early pregnancy experience multiple symptom clusters that dynamically change over time, and there are numerous influencing factors. Therefore, standardized symptom cluster terminology and developed specific assessment tools remain research priorities. Currently, medical staff should consider routine screening with the aforementioned validated tools to promptly identify high-risk symptom clusters, and subsequently develop personalized management plans. This scoping review provides a foundation for enhancing clinical symptom management efficiency.