According to research published by the American Psychological Association, women who experience anxiety about their pregnancies give birth earlier on average than those who do not.
The study, which examined the relationship between the length of pregnancy and different measures of anxiety, could help doctors understand when and how best to detect anxiety during pregnancy to help prevent preterm birth .
“Anxiety about a current pregnancy is a powerful psychosocial state that can affect birth outcomes,” said lead study author Christine Dunkel Schetter, PhD, of the University of California, Los Angeles.
“These days, depressive symptoms are assessed in many clinical settings around the world to prevent the complications of postpartum depression for mothers and children. This and other studies suggest that we should also assess anxiety in pregnant women”.
The study was published in the journal Health Psychology.
Previous research has found that up to one in four pregnant women have clinically elevated anxiety symptoms, and that anxiety can be a risk factor for preterm birth, or birth before 37 weeks of pregnancy.
However, these studies have used a variety of measures of anxiety and have looked at both general anxiety and pregnancy-specific anxiety, which includes concerns about childbirth, parenting, and the health of the baby.
Researchers have also measured anxiety at different points in pregnancy, from the beginning to the end of pregnancy and most often in the second trimester.
To sort out these different effects of timing and type of anxiety, 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 identify as non-Hispanic white, 36% as white Hispanic, 10% as Asian, and 9% as black or African American.
The researchers administered four different anxiety scales to women in both the first and third trimesters of their pregnancies. One was a five-question screener for general anxiety and three were pregnancy-specific: a 10-question scale and a four-question scale of pregnancy-related anxiety and a nine-question assessment of ‘a wider range of pregnancy-related stressors, such as medical care and worries about caring for a newborn.
The researchers found that participants’ scores on the three pregnancy-related anxiety scales were intercorrelated, suggesting that the scales are measuring the same underlying thing.
They also found that pregnancy-related anxiety in the third trimester was more strongly associated with earlier births. However, general anxiety in the first trimester also contributed to the risk of preterm birth.
One possibility, the researchers say, is that general anxiety early in pregnancy could predispose women to anxiety later in pregnancy about issues such as medical risks, the baby, labor and delivery, and parenting
The results held even after adjusting for the actual medical risk of the women’s pregnancies.
“Although not all women who begin pregnancy with general anxiety symptoms will later experience pregnancy-specific anxiety, our findings suggest that women who continue this progression are likely to be particularly at risk for a part earlier,” said Dunkel Schetter.
The results suggest that doctors should screen women for general anxiety early in pregnancy, he added, in the same way they usually screen for depression, and that women who score high could be screened for increased anxiety and possible intervention later in pregnancy.
According to Dunkel Schetter, further research should continue to explore the reasons why pregnancy anxiety is related to the timing of delivery, including neuroendocrine changes related to stress, inflammation and health behaviors.
“Increasing precision in our understanding of both the risks and mechanisms of the effects of pregnancy anxiety on gestational length may improve our ability to develop, test and implement interventions to address the urgent health problem public of preterm birth,” he said.
About this research news about anxiety and pregnancy
Author: Leah Winerman
Contact: Lea Winerman – APA
Image: The image is in the public domain
Original research: Findings will appear in Health Psychology