It is well known that stress and anxiety during pregnancy can have a negative impact on both the mother and the developing baby. High levels of stress and anxiety have been linked to a variety of negative outcomes, including preterm birth (birth before 37 weeks of pregnancy).
Preterm birth can increase the risk of health problems for the baby, including respiratory distress, developmental delays, and increased risk of infection. It is important for pregnant women to take steps to manage their stress and anxiety, such as talking to their healthcare provider, getting support from loved ones, and finding healthy ways to relax and manage their emotions.
According to research published by the American Psychological Association, women who are anxious about their pregnancies give birth earlier on average than those who are not. The study, which looked at the relationship between pregnancy length and various anxiety measures, could help doctors figure out when and how to screen for anxiety during pregnancy to help prevent preterm birth.
“Anxiety about a current pregnancy is a powerful psychosocial state that can influence birth outcomes,” said lead study author Christine Dunkel Schetter, PhD, of the University of California, Los Angeles. “Depressive symptoms are now assessed in many clinic settings around the world to prevent postpartum depression complications for mothers and children. This and other studies suggest that we should assess anxiety in pregnant women as well.”
Anxiety about a current pregnancy is a powerful psychosocial state that can influence birth outcomes. Depressive symptoms are now assessed in many clinic settings around the world to prevent postpartum depression complications for mothers and children. This and other studies suggest that we should assess anxiety in pregnant women as well.
Christine Dunkel Schetter
The findings were reported in the journal Health Psychology. Previous research has discovered that up to one in every four pregnant women has clinically elevated anxiety symptoms, and that anxiety can be a risk factor for preterm birth, or birth before 37 weeks. Those studies, however, used a variety of anxiety measures and examined both general anxiety and pregnancy-specific anxiety, which includes concerns about childbirth, parenting, and the baby’s health. Researchers have also measured anxiety at various stages of pregnancy, from early to late pregnancy, with the second trimester being the most common.
The 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 to sort out these various effects of timing and anxiety type. Women identified as non-Hispanic white 45% of the time, Hispanic white 36% of the time, Asian 10% of the time, and Black or African American 9% of the time.
The women were given four different anxiety scales by the researchers in both the first and third trimesters of their pregnancies. One was a five-question screener for general anxiety, and the other three were pregnancy-specific: a 10-question and four-question scale of pregnancy-related anxiety, and a nine-question assessment of a broader range of pregnancy-related stressors, such as medical care and concerns about caring for a newborn.
The researchers found that participants’ scores on all three scales of pregnancy-related anxiety were interrelated, suggesting that the scales measure the same underlying thing.
They also discovered that pregnancy-related anxiety was most strongly associated with earlier births during the third trimester. However, general anxiety during the first trimester increased the risk of premature birth. According to the researchers, one possibility is that general anxiety early in pregnancy may predispose women to be anxious later in pregnancy about issues such as medical risks, the baby, labor and delivery, and parenting. Even after adjusting for the actual medical risk of the women’s pregnancies, the results remained consistent.
“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.
The results suggest that doctors should screen women for general anxiety early in pregnancy, she added, just as they commonly screen for depression, and that women who score high could be monitored for increases in anxiety and possible intervention later in pregnancy.
According to Dunkel Schetter, more research should be conducted to investigate the reasons that pregnancy anxiety is linked to birth timing, such as stress-related neuroendocrine changes, inflammation, and health behaviors.
“Improving precision in our understanding of both the risks and mechanisms of pregnancy anxiety’s effects on gestational length can improve our ability to develop, test, and implement interventions to address the pressing public health issue of preterm birth,” she said.
