Association between maternal anxiety in pregnancy and increased uterine artery resistance index: Cohort based study

Centre for Fetal Care, Division of Paediatrics, Obstetrics and Gynaecology, Queen Charlotte's and Chelsea Hospital, London W6 0XG.
BMJ Clinical Research (Impact Factor: 14.09). 01/1999; 318(7177):153-7. DOI: 10.1136/bmj.318.7177.153
Source: PubMed


To investigate whether maternal anxiety in the third trimester is associated with an increased uterine artery resistance index. Design: Cohort based study.
100 pregnant women, with a mean gestation of 32 weeks.
Self rating Spielberger questionnaire for state anxiety and trait anxiety, and uterine blood flow waveform patterns as assessed by colour Doppler ultrasound.
A significant association was found between uterine artery resistance index and scores for both Spielberger state anxiety and trait anxiety (rs=0.31, P<0.002 and 0.28 P<0.005 respectively). Women with state anxiety scores >40 (n=15) had a higher mean uterine resistance index than those with scores </= 40 (mean difference with mean resistance index 24%, 95% confidence interval 12% to 38%; P<0.0001). Similarly, women with trait anxiety scores >40 (n=32) had a higher mean resistance index than those with scores </= 40, although to a lesser extent. The presence of notches in the waveform pattern produced by uterine artery blood flow was found in 4/15 (27%) women with high state anxiety scores compared with 4/85 (5%) with low anxiety scores (P<0.02).
This study shows an association between maternal anxiety in pregnancy and increased uterine artery resistance index. It suggests a mechanism by which the psychological state of the mother may affect fetal development, and may explain epidemiological associations between maternal anxiety and low birth weight. The influence of maternal anxiety may be one mechanism by which the intrauterine environment contributes to later disease in offspring.

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Available from: Vivette Glover, Mar 20, 2014
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    • "It is widely recognised that stress during pregnancy may affect neuroendocrine development in the foetus and the formation of a secure attachment bond with the newborn and, consequently, the socio-emotional development of the child (Campbell and Cohn, 1997; Jacobsen, 1999). High anxiety during pregnancy has been linked to lower birth weight, shorter birth length, shorter gestations (Hosseini et al., 2009) and increased uterine artery resistance (Teixeira et al., 1999). Anxiety in pregnancy could have long-term effects on children's behavioural/emotional problems (O'Connor et al., 2002). "
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    ABSTRACT: The aim of the study was to assess the prevalence of stress and anxiety, as well as the association that exists between stress/anxiety and sociodemographic characteristics, among pregnant women at the Tamale West Hospital in Ghana. This study was conducted among 154 pregnant women vis-iting the Tamale West hospital for antenatal care, from March to May, 2015. All participants were evaluated using a Self-designed semi-structured questionnaire for socio-demographic information, the Center for Epidemiological Studies Depression Scale (CES-D) for stress assessment and State Trait Anxiety Inventory (STAI) for assessment of anxiety. The response rate was 96.3%, with an age range of 17-42. Whereas 43.5% of the studied population were illiterate, 24.0% had attained basic education, 21.4% had attained secondary education while only 11.0% had attained tertiary educa-tion. Most of the studied participants were unemployed (57.8%), with a mean ± s.d. income level of Ghc 103.4±207.9. Almost all of them were married (96.8%) with mean ± s.d. marriage duration of 6.2±4.8 years, mean ± s.d. number of birth of 1.7±1.4 as well as mean ± s.d. gestation week of 21.3±10.9 weeks. Almost all the pregnant women had no complication in the current pregnancy (99.4%) as well as in their previous pregnancy (96.1%). The mean ± s.d. of anxiety score as well as stress score from the studied population were 15.3±3.2 and 13.2±4.9 respectively. The prevalence of anxiety was 9.7% whiles that for stress among these studied participants was 28.6%. Higher propor-tion (26.6%) of educated women had anxiety disorders with a lower (21.9±10.8) mean gestation peri-od being associated with anxiety disorders. Age was higher (28.1±5.8; p=0.0155) in women with pregnancy specific stress than in normal women (25.0±7.9). A higher proportion of women who were married (99.1%; 0.0097) were normal as compared to those who had pregnancy stress (90.9%). Mean number of births was seen to be higher among normal women (4.3±5.9; 0.0054) than those with stress (1.8±1.4). This study reiterates the rising levels of pregnancy specific stress and anxiety, with social and medical factors such as literacy levels, gestational period, age, marital status and parity playing major roles in the determination of pregnancy related stress and anxiety levels.
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    • "In addition, results fromHenrichs et al. (2010)suggested that the impact of maternal stress on foetal growth is even stronger in the last trimester of pregnancy, when foetal growth is essentially affected more by maternal and intrauterine environments than by genetic factors (Styne, 1998;WHO, 2006a). These results seem to confirm that maternal stress affects not only the physiology of parturition but also foetal growth and maturation, probably by compromised uteroplacental perfusion (Teixeira et al., 1999) and excessive foetal exposure to maternal glucocorticoids (Challis et al., 2001). Further analysis should clarify why the economic crisis in Spain is affecting maternal conditions and gestation by reducing weight at birth—as our results seem to confirm—but not timing of birth, as could be expected considering that the economic recession was affecting maternal conditions and DOI: 10.3109/03014460.2015.1131847 "

    Full-text · Article · Dec 2015 · Annals of Human Biology
    • "Anxiety during pregnancy is associated with several adverse maternal and child outcomes, such as postpartum depression (Ahluwalia et al., 2004; Heron et al., 2004; Skouteris et al., 2009), preterm birth, low birth weight (Littleton et al., 2007; O'Donnell et al., 2011; Teixeira et al., 1999), and subsequent developmental and mental health challenges in children (Buss et al., 2011; Davis and Sandman, 2012; Kingston et al., 2012; Loomans et al., 2012). Available data suggest that PrA may be more strongly associated with maternal and child outcomes than general anxiety or depressive symptoms are and may predict these outcomes more accurately (Blair et al., 2011; Kramer et al., 2009; Lobel et al., 2008). "
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    ABSTRACT: Evidence suggests that pregnancy-related anxiety is more strongly associated with maternal and child outcomes than general anxiety and depression are and that pregnancy-related anxiety may constitute a distinct concept. However, because of its poor conceptualization, the measurement and assessment of pregnancy-related anxiety have been limited. Efforts to analyze this concept can significantly contribute to its theoretical development. The first objective of this paper was to clarify the concept of pregnancy-related anxiety and identify its characteristics and dimensions. The second aim was to examine the items of current pregnancy-related anxiety measures to determine the dimensions and attributes that each scale addresses, noting any gaps between the current assessment and the construct of the concept.
    No preview · Article · Nov 2015 · International journal of nursing studies
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