<![CDATA[Objective: To estimate the prevalence of perceived stress and identify its associated risk factors among rural pregnant women. Methods: A community-based cross-sectional study was conducted among 250 antenatal mothers (gestation >12 weeks) in rural Kancheepuram District, Tamil Nadu, over two years (January 2017 – December 2018). Data on demographic, obstetric, and lifestyle factors were collected using a semi-structured questionnaire. The Perceived Stress Scale (PSS) was used to assess stress levels. Results: Among the 250 participants, the mean perceived stress score was 14.4 ± 4.01. The prevalence of moderate stress was 51.2% (n=128), while 48.8% (n=122) reported low stress. Significant associations with higher stress were found for age (p=0.021), occupation (p=0.009), education (p=0.000), and lower socioeconomic status (p=0.003). Additionally, participants with thyroid disorders (p=0.022) and a history of infertility treatment (p=0.004) reported significantly higher stress levels. No significant association was found between stress and obstetric parameters such as gravida or parity. Conclusion: This study found a high prevalence of moderate perceived stress among rural pregnant women. Key risk factors include lower socioeconomic status, occupation, and specific comorbidities. These findings underscore the need for routine psychosocial screening and early intervention, particularly for at-risk groups. Comprehensive support strategies must be integrated into antenatal care to promote maternal well-being and improve pregnancy outcomes. Keywords: antenatal care, perceived stress, pregnancy, rural health, tamil nadu]]>
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