Women with pregnancy anxiety give birth earlier than those without, according to new research published by APA.
This study, which studied the association between the length of a pregnancy and several measures of anxiety, may assist medical professionals in determining when and how it is most effective to screen pregnant women for anxiety in order to reduce the risk of giving birth prematurely.
Leading study author Christine Dunkel Schetter, PhD, of the University of California, Los Angeles, explained that “anxiety about a current pregnancy” is a strong psychological state that may alter “birth outcomes”.
The findings of the study were presented in the academic journal Health Psychology.
Previous studies have shown that clinically elevated anxiety symptoms can occur in up to one in four pregnant women and that anxiety can increase the chance of preterm birth, or delivery before 37 weeks of pregnancy. However, those studies used a range of anxiety measures and included both general anxiety and anxiety specific to pregnancy, which includes concerns about birthing, parenting, and the health of the unborn child. Researchers have also assessed anxiety at various stages of pregnancy, from early to late pregnancy, with the majority of measurements occurring in the second trimester.
To figure out these different effects of timing and type of anxiety, researchers looked at data from the Healthy Babies Before Birth study. This study looked at 196 pregnant women from Denver and Los Angeles. The majority of the women (45%) identified as non-Hispanic white, followed by Hispanic white (36%), Asian (10%), and Black or African American (9%).
In the first and third trimesters of their pregnancies, the researchers gave the women four different anxiety scales. Three of them were specific to pregnancy: a 10-question scale of anxiety related to pregnancy, a four-question scale of anxiety related to pregnancy, and a nine-question assessment of a wider range of pregnancy-related stressors, such as medical care and concerns about taking care of a newborn. One was a five-question screener for general anxiety.
The researchers found that the scores of the participants on all three scales of anxiety related to pregnancy were related. This suggests that all three scales are measuring the same thing.
They also found that anxiety during the third trimester of pregnancy was most strongly linked to babies being born earlier. However, preterm birth risk was also influenced by widespread worry during the first trimester. According to the researchers, it’s possible that early-pregnancy anxiety in general predisposes women to later-pregnancy concern about things like health risks, the baby, labor and delivery, and parenthood. Even after accounting for the real medical risk of the women’s pregnancies, the findings remained valid.
“Although not all women who begin pregnancy with general anxiety symptoms will later experience pregnancy-specific anxiety,” adds Dunkel Schetter, “our results suggest that women who do follow this progression are likely to be especially at risk for earlier delivery.”
She noted that the data imply that clinicians should screen women for general anxiety early in pregnancy, similar to how they routinely screen for depression, and that women with high scores should be observed for anxiety rises and possible treatments later in pregnancy.
Dunkel Schetter says that more research needs to be done to find out why stress-related changes in neuroendocrine systems, inflammation, and health behaviors may be linked to when a baby is born.
“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,” she adds.
Source: 10.1037/hea0001210
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