A Literature Review of Pregnancy Worries and Stress Scales

Abstract

Context: High levels of worries and stress in pregnancy result in negative pregnancy outcomes and postnatal depression. Despite recommendations for routine psychological evaluation of pregnant women, there is a lack of scales specifically designed to measure stress during pregnancy. Evidence Acquisition: PubMed, Medline, Scopus, ISI Web of Knowledge, ScienceDirect, PsycINFO, and Google Scholar databases were searched for English articles published during 1983 - 2016. The consensus-based standards for the selection of health status measurement instruments (COSMIN) checklist was used for assessing the methodological quality of the studies. Results: A total of 27 studies were included, and 27 different instruments were identified. Validity and reliability assessments were performed in all the papers. According to the COSMIN checklist, the overall quality of the papers was fair to excellent. Among all the instruments, the pregnancy worries and stress questionnaire (PWSQ) and pregnancy-related anxiety questionnaire (PRAQ) showed moderate to strong evidence in most of the evaluated measurement properties. Conclusions: A few scales with acceptable theoretical and psychometric properties are available for the measurement of pregnancy worries. General tools previously adopted to assess worries and stress in pregnancy need further psychometric testing to confirm their reliability and suitability for the prenatal period. The results of this study indicated that while none of the evaluated tools was completely suitable for the assessment of worries and stress in pregnancy, the PWSQ and PRAQ showed moderate to strong evidence in most of the examined measurement properties.