Pregnancy-related anxiety associated with earlier delivery

Pregnant women who had anxiety about their current pregnancy had a greater risk for early delivery, with third trimester anxiety having the strongest association with early birth, according to a prospective cohort study.

“Anxiety about a current pregnancy is a potent psychosocial state that may affect birth outcomes,” Christine Dunkel Schetter, PhD, a professor of health and social psychology at the University of California, Los Angeles, said in a press release. “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.

Anxiety scores were combined to create a single latent pregnancy anxiety factor, which Dunkel Schetter and colleagues used to determine whether anxiety was linked to earlier delivery.

The latent factor as assessed during the first trimester was not significantly associated with the timing of delivery. 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 did significantly predict length of gestation, such that greater anxiety levels were associated with earlier delivery. 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.”

References:

• Anxiety during pregnancy can lead to earlier births, study finds. https://www.eurekalert.org/news-releases/965600. Published Sept. 26, 2022. Accessed Sept. 27, 2022.
• Dunkel Schetter C, et al. Health Psychol. 2022;doi:10.1037/hea0001210.