Anxiety during pregnancy related to previous births

Anxiety during pregnancy related to previous births

According to a study published by the American Psychological Association, women who are afraid of pregnancy give birth earlier on average than those who are not afraid.

The study, which examined the association between length of pregnancy and various measures of anxiety, could help doctors understand when and how best to screen for anxiety during pregnancy to prevent preterm birth.

Fear of current pregnancy is a powerful psychosocial condition that can impact the birth process. Nowadays, depressive symptoms are examined in many clinics around the world to prevent complications of postpartum depression for mothers and children. These and other studies suggest that we should also assess anxiety in pregnant women.”

Christine Dunkel Schetter, PhD, lead author of the study, University of California Los Angeles

The study was published in the journal Health Psychology.

Previous research has found that up to one in four pregnant women have clinically elevated symptoms of anxiety and that anxiety may be a risk factor for premature birth or birth before 37 weeks of pregnancy. However, these studies used different measures of anxiety and examined both general anxiety and pregnancy-specific anxiety, which includes worries about birth, parenting, and the baby's health. Researchers have also measured anxiety at different points in pregnancy, from early to late pregnancy and most commonly in the second trimester.

To clarify these different effects of timing and anxiety type, researchers examined data from a diverse sample of 196 pregnant women in Denver and Los Angeles who participated in the Healthy Babies Before Birth study. Forty-five percent of women identified as non-Hispanic white, 36% as Hispanic white, 10% as Asian, and 9% as black or African American.

The researchers administered four different anxiety scales to the women in both the first and third trimesters of their pregnancy. One was a five-question screener for general anxiety and three were specific to pregnancy: a ten- and four-question scale for pregnancy-related anxiety and a nine-question assessment of a broader range of pregnancy-related stressors, such as medical care and worries about caring for a newborn.

The researchers found that participants' scores on all three pregnancy-related anxiety scales were related, suggesting that the scales measure the same underlying problem.

They also found that pregnancy-related anxiety in the third trimester was most strongly associated with previous births. However, general anxiety in the first trimester also contributed to the risk of premature birth. According to the researchers, one possibility is that general anxiety early in pregnancy could lead women to worry later in pregnancy about issues such as medical risks, the baby, labor and delivery, and parenting. The results held even when the actual medical risk of the women's pregnancies was taken into account.

"Although not all women who begin pregnancy with general anxiety symptoms will experience pregnancy-specific anxiety later, our results suggest that women who follow this progression are likely at particular risk for earlier delivery," said Dunkel Schetter.

The findings suggest that doctors should screen women for general anxiety early in pregnancy, just as they typically do for depression, and that women with high scores could be monitored for an increase in anxiety and possible interventions later in pregnancy.

According to Dunkel Schetter, further research should continue to examine the reasons why pregnancy anxiety is related to the timing of birth, including stress-related neuroendocrine changes, inflammation and health behaviors.

“Increasing precision in our understanding of both the risks and mechanisms of the effects of pregnancy anxiety on pregnancy length may improve our ability to develop, test and implement interventions to address the pressing public health problem of preterm birth,” she said.

Source:

American Psychological Association

Reference:

Dunkel Schetter, C., et al. (2022) Anxiety during pregnancy and duration of pregnancy: Findings from the “Healthy Babies Before Birth” study. Health psychology. doi.org/10.1037/hea0001210.