Anxiety during pregnancy can lead to earlier births, study finds

Anxiety during pregnancy can lead to earlier births, study finds
Structural equation model testing single latent factor of pregnancy anxiety. Credit: Health Psychology (2022). DOI: 10.1037/hea0001210

Women who experience anxiety about their pregnancies give birth earlier on average than those who don't, according to research published by the American Psychological Association.

The study, which examined the relationship between pregnancy length and different measures of , 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, Ph.D., of the University of California Los Angeles. "These days, 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 ."

The study was published in the journal Health Psychology.

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. However, those studies have used a variety of measures of anxiety and have looked at both general anxiety and pregnancy-specific anxiety, which includes worries about childbirth, parenting and the baby's health. Researchers have also measured anxiety at different points in pregnancy, from early to late pregnancy and most often in the second trimester.

To sort out these various effects of timing and anxiety type, 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. Forty-five percent of the women identified as non-Hispanic white, 36% as Hispanic white, 10% as Asian and 9% as Black or African American.

The researchers 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, and a nine-question assessment of a broader range of pregnancy-related stressors, such as and worries about taking care of 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 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. One possibility, according to the researchers, is that general anxiety early in pregnancy could predispose women to be anxious later in pregnancy about such issues as medical risks, the baby, labor and delivery, and parenting. The results held even when adjusted for the actual medical risk of the women's pregnancies.

"Although not all women who begin pregnancy with general 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.

Further research should continue to explore reasons that pregnancy anxiety is linked to timing, including stress-related neuroendocrine changes, inflammation and health behaviors, according to Dunkel Schetter.

"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 ," she said.

More information: Christine Dunkel Schetter et al, Anxiety in pregnancy and length of gestation: Findings from the healthy babies before birth study, Health Psychology (2022). DOI: 10.1037/hea0001210

Journal information: Health Psychology
Citation: Anxiety during pregnancy can lead to earlier births, study finds (2022, September 26) retrieved 22 February 2024 from
This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.

Explore further

Pregnant women with epilepsy have more depression, anxiety symptoms


Feedback to editors