Adherence to medical recommendations in high-risk pregnancy: dispositional and situational predictors with a focus on emotional reactivity

Objective Therapeutic adherence during pregnancy is critical for maternal and fetal health. This study examines personality traits, sensitivity to stimuli and socio-demographic factors influencing adherence among Italian women with high-risk pregnancies. Methods Ninety women from “Villa Sofia—V. Cervello Hospital”, in Palermo, Italy, participated. Personality traits were assessed via the Personality Inventory (PI), covering Extraversion, Conscientiousness, Neuroticism, Mental Openness, and Friendliness. Sensitivity to stimuli was evaluated using the Highly Sensitive Person (HSP) Scale, which includes Low Sensory Threshold (LST), Ease of Excitement (EOE), and Aesthetic Sensitivity (AES). Treatment adherence was measured using the Morisky Medication Adherence Scale (MMAS). Results Conscientiousness was identified as a positive predictor of medication adherence (OR = 1.08, p = .010), while Mental Openness (OR = 0.81, p = .003) and EOE (OR = 0.92, p = .014) were negative predictors. Higher education levels were associated with better adherence (OR = 2.34, p = .006). Significant occupational differences emerged, with office clerks exhibiting higher adherence compared to housekeepers (OR = 3.18, p = .008). Planned (OR = 0.38, p = .025) and unplanned but wanted pregnancies (OR = 0.42, p = .045) showed lower adherence. Regression analysis indicated that Neuroticism (β = −0.21, p = .032) and EOE (β = −0.28, p = .008) negatively impacted adherence. Conclusion Specific personality traits, sensitivity, education, occupation, and pregnancy significantly influence adherence. Tailored interventions that enhance conscientiousness, address mental openness and sensitivity, and consider individual socio-demographic context are needed to promote better adherence and improve maternal and fetal health outcomes in high-risk pregnancies.