Abstract
Background and aimPrenatal diagnosis of fetal abnormalities is a critical and stressful event for women. Most pregnant women are concerned about fetal abnormalities and screening tests. Due to the importance of anxiety reduction in pregnant women, this study was conducted to determine the effect of short-term psychological intervention on the anxiety of pregnant women with positive screening results for chromosomal disorders.MethodsA randomized clinical trial was performed on women referred to Akbarabadi Hospital in Tehran, Iran, who had positive screening results for chromosomal abnormalities. Participants were selected from eligible individuals by a continuous method and were assigned to two groups of cognitive-behavioral training (n = 46) and control (n = 46), using the block balanced randomization method. Participants in the cognitive-behavioral training group received 4 sessions of individual counseling. The control group received routine pregnancy visits. The Spielberger State-Trait Anxiety Inventory was completed before the intervention and immediately at the end of the intervention (before receiving the amniocentesis result). The analysis of intervention effects was performed as intention-to-treat and per-protocol analysis.ResultsThere was a statistically significant difference in post-intervention state anxiety scores and trait anxiety scores (p < 0.001) between the intervention and control groups, when their means were adjusted for pre-intervention scores for both intention-to-treat and per-protocol analysis. Also, there was a large effect size between the groups in terms of state (ITT: ηp2 = 0.63, PP: ηp2 = 0.71) and trait (ITT: ηp2 = 0.72, PP: ηp2 = 0.75) anxiety scores clinically for both intention-to-treat and per-protocol analysis. The intervention group had a statistically significant and large decrease in state and trait anxiety scores from pretrial to post-trial. In contrast, the control group had a statistically significant and medium increase in state and trait anxiety scores from pretrial to post-trial.ConclusionThe results showed that cognitive-behavioral training reduced the anxiety of pregnant women with positive screening results for chromosomal disorders. According to the results, it is recommended to hold cognitive-behavioral training classes to reduce the anxiety of pregnant women with a positive screening result for chromosomal disorders.Trial registrationIRCT.ir: IRCT20180427039436N7; date of registration: 24/08/2020 2020-08-24.
Highlights
Pregnancy is an important stage in women’s life, and confronts them with the growth of another human being inside their body, which is associated with many psychological, emotional, and physical pressures [1]
In the control group, 4 people were excluded (3 due to abortion during the study and 1 for unwillingness to continue with the study)
The results of the current study showed a statistically and clinically significant difference in the state and trait anxiety scores of the cognitive-behavioral training group after the intervention compared to the control group
Summary
Pregnancy is an important stage in women’s life, and confronts them with the growth of another human being inside their body, which is associated with many psychological, emotional, and physical pressures [1]. It increases the vulnerability and anxiety of women [2]. According to the results of a meta-analysis by Dennis et al, the prevalence of anxiety in the first, second and third trimester is 19.2, 18.1, and 24.6%, respectively [4] In this regard, studies in Iran have assessed pregnancyrelated anxiety by general anxiety questionnaires and reported prevalence rates of 32.5 and 40% [5, 6]. Due to the importance of anxiety reduc‐ tion in pregnant women, this study was conducted to determine the effect of short-term psychological intervention on the anxiety of pregnant women with positive screening results for chromosomal disorders
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