September 29, 2022
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A prospective cohort study found that pregnant women with anxiety about their current pregnancy were more likely to have an early delivery. The strongest association was between third-trimester anxiety and early birth.
“Anxiety about a current pregnancy is a potent psychosocial state that may affect birth outcomes,” Christine Dunkel Schetter, PhD, A press release was issued by a professor of psychology and health at University of California, Los Angeles. “These days, depressive symptoms are assessed in many clinic settings around the world to prevent complications of postpartum depression for mothers and children. This and other studies suggest that we should also be assessing anxiety in pregnant women.”
Dunkel Schetter and colleagues screened 196 pregnant women — 42.9% of whom attended a large urban medical center in Denver and 57.1% of whom attended a center in Los Angeles — for general and pregnancy-associated anxiety.
During both the first and third trimesters, the researchers used four separate scales to assess women’s concerns about their baby’s and their own health, labor and delivery and parenting; to assess women’s feelings about pregnancy over the past week; to identify distress related to prenatal care and postpartum life; and to examine the general impact of anxiety on women’s lives.
Dunkel Schetter and co-workers created a single latent factor for anxiety in pregnancy. It was combined with anxiety scores. Dunkel Schetter used this factor to determine if anxiety was associated with earlier deliveries.
The timing of delivery was not associated with the latent factor, as it was measured in the first trimester. However, separate analyses of first trimester anxiety scores showed that scores on the Overall Anxiety Severity and Impairment Scale — which examined the general impact of anxiety on women’s lives — were associated with earlier delivery.
“Although not all women who begin pregnancy with general anxiety symptoms will later experience pregnancy-specific anxiety, our results suggest that women who do follow this progression are likely to be especially at risk for earlier delivery,” Dunkel Schetter said in the release.
The third trimester Latent Factor was significant in predicting length of gestation. Therefore, earlier delivery was associated with higher anxiety levels. Specifically, separate analyses of anxiety scores revealed that the third trimester scores from the Pregnancy-Specific Anxiety Scale — which assessed anxiety related to women’s feelings about pregnancy over the past week — were significantly associated with earlier delivery.
“Beyond these findings, this study strongly supports further research on prenatal anxiety screening,” Dunkel Schetter and colleagues wrote. “Increasing precision in our understanding of both the risks and mechanisms of the effects of pregnancy anxiety on gestational length can improve our ability to develop, test and implement interventions to address the pressing public health issue of preterm birth.”
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