Women who experience anxiety during pregnancy may give birth earlier compared to those who don't, according to a study. The research, published recently in the journal Health Psychology, could help doctors understand when and how best to screen for anxiety during pregnancy to help prevent preterm birth.
"Anxiety about a current pregnancy is a potent psychosocial state that may affect birth outcomes," said lead study author Christine Dunkel Schetter, from the University of California Los Angeles, US.
"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 said.
Previous research has found that up to one in four pregnant women has clinically elevated anxiety symptoms and that anxiety can be a risk factor for preterm birth, or birth before 37 weeks of pregnancy.
In the latest study, the researchers examined data from a diverse sample of 196 pregnant women in Denver and Los Angeles who took part in the Healthy Babies Before Birth study.
They administered four different anxiety scales to the women, in both the first and the third trimesters of their pregnancies.
One was a five-question screener for general anxiety and three were specific to pregnancy: a 10-question and a four-question scale of pregnancy-related anxiety.
Another was a nine-question assessment of a broader range of pregnancy-related stressors, such as medical care and worries about taking care of a newborn.
The researchers found that pregnancy-related anxiety in the third trimester was most strongly associated with earlier births.
However, general anxiety in the first trimester also contributed to risk for early birth, they said.
The researchers noted that general anxiety early in pregnancy could predispose women to be anxious later in pregnancy about such issues as medical risks, the baby, labour and delivery, and parenting.
The results held even when adjusted for the actual medical risk of the women's pregnancies, they said.
"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 study suggests that doctors should screen women for general anxiety early in pregnancy just as they commonly screen for depression.
Women who score high could be monitored for increases in anxiety and possible intervention later in pregnancy, the researchers added.