Pregnancy-Related Anxiety Questionnaire-Revised 2 Research Articles

The Relationship Between Marriage Satisfaction and Anxiety of Pregnant Women in Facing Childbirth

The birth process is interpreted by a mother as a difficult process and full of struggle so it causes anxiety for pregnant women in facing childbirth. Excessive anxiety has a negative impact on the birth process and even causes birth complications. This study aimed to determine the relationship between marriage satisfaction and the anxiety of pregnant women in facing childbirth. This research used a cross-sectional method and the number of pregnant women in the Central Jakarta area with a sample size of 110 people. The research instrument used the Pregnancy-Related Anxiety Questionnaire-Revised 2 (PRAQ-2) questionnaire and the Marital Adjustment Test (MAT) questionnaire. In this study, data analysis used the Spearman Rho test. The results of this study show that there is a significant relationship between marriage satisfaction and anxiety about facing childbirth (p value=0.036). Marriage satisfaction has a fairly large influence on pregnant women's anxiety in facing childbirth in the moderate category (R Square=0.051). The role of the maternity nurse is to be able to take preventive measures to reduce the heavy or excessive anxiety of pregnant women through mentoring and counseling programs together with the family, especially the husband.

The relationship between pregnancy-related anxiety, trait anxiety, and internet use in pregnant women: a cross-sectional study

Introduction: Pregnancy-related anxiety leads to some negative maternal and fetal complications. Determining prenatal and natal anxiety and associated factors can help identify high-risk women who need intervention during pregnancy and develop early intervention strategies. The aim of this study is to determine pregnancy-related, and trait anxiety in the prenatal period and its affecting factors. Methods: This cross-sectional and descriptive study was conducted with 245 pregnant women in the obstetrics clinic of a tertiary healthcare institution between March and August 2022. The sociodemographic, obstetric, and internet use of the participants were questioned. Pregnancy-related anxiety was assessed by using Pregnancy-Related Anxiety Questionnaire-Revised-2 (PRAQ-R2), and trait anxiety was assessed by using State–Trait Anxiety Inventory-I (STAI-II). Results: Pregnant women’s mean scale score for STAI (trait) was 45.54 ± 6.32, for PRAQ-R2 total score was 27.80 ± 8.32, for PRAQ- Fear of giving birth score was 10.12 ± 3.92, PRAQ- Worries about bearing a physically or mentally handicapped child score was 10.44 ± 4.11, and PRAQ- Concern about own appearance score was 7.24 ± 2.86. Pregnancy-related Anxiety Scale score was higher in nulliparous than multiparous (p=0.002) and 30-35 age groups than others (p=0.014). Having a chronic disease is related to a higher anxiety score (p=0.028). Trait anxiety scores were higher in nulliparous (p=0.005), those with low income, those with chronic diseases (p=0.032), and those with a history of children with congenital diseases (p=0.013). Anxiety scores were higher in pregnant women who used the internet as a source of information about pregnancy (p=0.002), and those who use the internet more (p=0.023). There was a significant positive correlation between STAI (trait) anxiety and PRAQ total score ( r:0.292, p<0.001 ), PRAQ- Fear of giving birth (r:0.145, p=0.024), PRAQ- Worries about bearing a physically or mentally handicapped child (r:0.270, p<0.001), and PRAQ- Concern about own appearance (r:0.254, p=<0.001). Conclusion: Pregnancy-related anxiety was higher in nulliparous, 30-35 age groups, having a chronic disease, husbands' high education status, and having trait anxiety. Information obtained from the internet and the time spent on the internet are associated with increased pregnancy anxiety. Future studies should focus more on predicting factors affecting pregnancy-related anxiety and estimating risks for pregnant women.

IJCM_18A: A Cross-sectional study on prevalence of pregnancy related anxiety among antenatal mothers attending Rural Primary Health Center, Kancheepuram

Background: With declining rates of maternal mortality worldwide, its time to recognize the importance of addressing morbidity as well. When compared with general anxiety, pregnancy-related anxiety appears to be a stronger determinant for poor obstetric consequences. Complications include miscarriage, low birth weight, impaired cognitive and physical fetal development, and possibly death. Objectives: To assess the prevalence of pregnancy related anxiety with severity and the associated factors. Methodology: A cross-sectional on was conducted among 113 antenatal mothers attending antenatal clinic (Tuesdays)in Kundrathur Rural Primary Health Centre by consecutive sampling. Data was collected by interviewer administering a validated and structured questionnaire PRAQ R2(Pregnancy Related Anxiety Questionnaire Revised 2) and statistical analysis was done using IBM SPSS version 25. Results: Among 113 antenatal mothers mean age was 25.19+4.2 years, 69.9% are primi gravida, 50.4% said that current pregnancy is planned. All of the mothers having complications in current pregnancy (22.1%) had pregnancy related anxiety. The mean scores of pregnancy related anxiety domains were 7.6 out of 15 for fear of giving birth, 4.9 out of 15 for concern of own appearance, and 10.9 out of 12 for worries about bearing a handicapped child. Nearly 89.4% of mothers have pregnancy-related anxiety with most of them having low severity anxiety (44.2%). The factors associated with pregnancy related anxiety (p < 0.05) were primi gravida and those in second and third trimester. Conclusion: A majority of the participants are experiencing pregnancy related anxiety with most of them having low severity anxiety worrying about outcome of birth. It’s predictors included Primigravida and those in second and third trimester. Pregnancy-related anxiety should be diagnosed early during routine antenatal mothers for better maternal and fetal outcomes

Elevated Depression, Anxiety and Hopelesness Among Pregnant Individuals with Ovarian Cyst

Background/Purpose:
 Anxiety and depression in pregnancy commonly presents between 10 and 25% of pregnant individuals. Increased symptoms of depression and anxiety are coupled with elevated risk of preterm birth, postpartum depression, and behavioral difficulties in children. Detection of ovarian cyst is a potential stressor factor for pregnant individuals. Our objective was to investigate the levels of anxiety, depression and hopelessness in pregnant individuals with ovarian cyst.
 Methods:
 In this comparative and descriptive study, a total of 184 pregnant women were divided into 2 groups. Group 1 encompasses pregnant women with ovarian cyst (n=86), and Group 2 includes healthy pregnant women as control (n=88). Data were collected using Demographic Questionnaire, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Beck Hopelessness Scale (BHS) and Pregnancy Related Anxiety Questionnaire-Revised 2 (PRAQ-R2).
 Results: We found substantially elevated BDI, BAI, BHS AND PRAQ-R2 scores in Group 1 according to Group 2 [(15.16±12.6, 6.45±5.6), (16.44±14.5, 7.61±5.2), (9.44±8.3, 4.10±5.2), (30.99±9.66, 27.2±4.90), respectively] (p>0.05). However, there wasn’t significant difference between groups in demographic characteristics (p>0.05).
 Conclusion: Anxiety, depression and hopelessness are observed more among pregnant women with ovarian cyst. Nevertheless, approximately 70 percent of all ovarian cysts spontaneously resolve during pregnancy and more than 90 percent of them are benign. Hence, the patient should be informed appropriately by obstetricians before referring them to tertiary centers, and this approach may mitigate their anxiety, depression and hopelessness.

Perceived Parenting Stress Is Related to Cardiac Flexibility in Mothers: Data from the NorBaby Study.

Heart rate variability (HRV) is an indicator of autonomic nervous system activity, and high levels of stress and/or depressive symptoms may reduce HRV. Here, we assessed whether (a) parental stress affected HRV in mothers during the perinatal period and whether this is mediated by bonding and (b) whether antenatal maternal mental states, specifically repetitive negative thinking, depressive symptoms, and pregnancy-related anxiety, have an impact on infant HRV, and lastly, we investigated (c) the relationship between maternal HRV and infant HRV. Data are from the Northern Babies Longitudinal Study (NorBaby). In 111 parent-infant pairs, cardiac data were collected 6 months after birth. In the antenatal period, we used the Pregnancy-Related Anxiety Questionnaire-Revised, the Edinburgh Postnatal Depression Scale, and the Perseverative Thinking Questionnaire; in the postnatal period, we used the Parenting Stress Index and the Maternal Postnatal Attachment Scale. Higher levels of perceived parenting stress but not depressive symptoms were associated with lower HRV in mothers (τ = -0.146), and this relationship was not mediated by maternal bonding. Antenatal maternal mental states were not associated with infant HRV. There was no significant correlation between maternal HRV and infant HRV. Our observational data suggest that perceived stress reduces cardiac flexibility. Future studies should measure HRV and parenting stress repeatedly during the perinatal period.

The role of perinatal maternal symptoms of depression, anxiety and pregnancy-specific anxiety for infant's self-regulation: A prospective longitudinal study

BackgroundMaternal symptoms of anxiety and depression are highly prevalent during pregnancy and postpartum and have the potential to impact fetal development and offspring behavior.However, research on the effects of fetal exposure to maternal subclinical affective symptoms on infant self-regulation is still lacking. Self-regulation provides a fundamental precondition for healthy development and overall life success whereas dysfunctional self-regulation can lead to behavioral problems, poor academic achievement, social rejection, and physical/mental disorders. During pregnancy and infancy, children largely depend upon their mothers in order to successfully regulate their internal states. Given the high prevalence of mothers suffering from anxiety and depressive symptoms during pregnancy and after childbirth, the aim of the present study is to explore how maternal affective symptoms change during the pre- and postnatal period, and how measures obtained in pregnancy and beyond impact self-regulation in infants, as indicated by crying-, sleeping-, and/or feeding problems. MethodsThis prospective longitudinal study investigates the effects of maternal symptoms of depression, anxiety, and pregnancy-specific anxiety on infant's self-regulation in N = 225 mother-infant dyads. Maternal affective symptoms were examined at five prenatal and three postnatal time-points using the Edinburgh Postnatal Depression Scale (EPDS), the State-Trait Anxiety Inventory (STAI) and the Pregnancy Related Anxiety Questionnaire Revised (PRAQ-R2). Infant's self-regulation was assessed twice - at the age of three and six months - using the Crying Feeding Sleeping Scale (SFS). ResultsMaternal pregnancy-specific anxiety was the most significant predictor for infant self-regulatory problems. It predicted crying-, sleeping, and feeding problems and explained up to 18 % of the variance. Even when controlling for maternal postpartum affective symptoms, pregnancy-specific anxiety remained a significant predictor for infant self-regulation problems. LimitationsRather homogenous sample (high socioeconomic status). Data based on maternal reports of infant behavior. ConclusionsOur results suggest that fetal exposure to maternal affective symptoms – specifically pregnancy-related anxiety - plays a substantial role in the development of infant self-regulation problems, potentially mediated by epigenetic modifications. Importantly, even though maternal symptoms of depression and anxiety only reached subclinical levels, they were predictive for infant crying-, sleeping-, and feeding problems. Our findings underline the importance of early prevention and clearly tailored interventions during pregnancy and postpartum to prevent adverse outcome for mother, child and family.

Psychological distress in subsequent pregnancy among women with a history of pregnancy loss: A latent profile analysis

BackgroundWomen who have undergone pregnancy loss can experience a range of psychological distress during subsequent pregnancies; however, the outcomes may vary based on individual circumstances. ObjectiveTo explore the potential patterns of psychological distress for pregnant women with a history of pregnancy loss, and to investigate the impact of factors related to pregnancy loss on these patterns. MethodsFrom October 2022 to August 2023, the participants were recruited from four medical centers in Guangdong Province, China. They completed a questionnaire survey comprising sociodemographic and obstetric characteristics, the Perceived Stress Scale-4 (PSS-4), the Impact of Event Scale-Revised (IES-R), the Pregnancy-related Anxiety Questionnaire-Revised 2 (PRAQ-R2), and the Patient Health Questionnaire-9 (PHQ-9). Latent profile analysis was used to determine optimal patterns of psychological distress. The logistic regression was conducted to assess the associations between the number of pregnancy loss, types of pregnancy loss, inter-pregnancy interval, and distinct psychological distress patterns. ResultsA total of 446 pregnant women with a history of pregnancy loss were included for formal analysis. Three distinct profiles were identified, namely the "mild psychological distress" (34.1 %), "moderate psychological distress" (57.8 %), and "severe psychological distress" (8.1 %). Recurrent pregnancy loss was associated with increased risks of both moderate (adjusted odds ratio [aOR] 2.45, 95 % confidence interval [CI]: 1.42–4.24; P = 0.001) and severe psychological distress (aOR 2.93, 95 %CI: 1.25–6.83; P = 0.013). Furthermore, compared to women who conceived after 6 months of pregnancy loss, those who conceived within 6 months of pregnancy loss were more likely to be categorized into the group of moderate psychological distress (aOR 2.00, 95 % CI: 1.21–3.30; P = 0.007). ConclusionsApproximately two-thirds of pregnant women with a history of pregnancy loss exhibit moderate to severe psychological distress. Such individuals could benefit from early screening and targeted psychological interventions, particularly those who have encountered recurrent pregnancy loss and those who conceive shortly after a pregnancy loss.

Knowledge and worries on motherhood choice in multiple sclerosis - a cross-sectional study on patient-reported outcome measures.

Since multiple sclerosis (MS) is often diagnosed in young women, pregnancy is a common topic for women with MS (wwMS). The study aimed to assess the measurement properties of two patient-reported outcome measures on motherhood choice in MS, and to explore the information and support needs of wwMS concerning motherhood. We conducted an anonymous web-based survey to validate the motherhood/pregnancy choice and worries questionnaire (MPWQ, 31 items plus up to 3 additional items) and the motherhood choice knowledge questionnaire (MCKQ, 16 items). We used mailing lists and social media for nationwide recruitment in Germany, and included women of childbearing age with relapsing-remitting MS, clinically isolated syndrome or suspected MS who were considering pregnancy or were pregnant. For the MPWQ, we assessed item difficulty, discriminatory power, and internal consistency (Cronbach's alpha; CA). We analysed construct validity using the Leipzig Questionnaire of Motives to have a Child, the Decisional Conflict Scale, the Hospital Anxiety and Depression Scale, and the Pregnancy-Related Anxiety Questionnaire-revised2. We studied the structural validity using exploratory factor analysis (EFA). The MCKQ was evaluated descriptively. We explored the information and support needs of wwMS on motherhood descriptively. We examined correlations between MCKQ, MPWQ and clinical characteristics and performed exploratory group comparisons considering the following binary variables: having children and being pregnant. 325 wwMS started the survey; 232 wwMS met our inclusion criteria and were analysed. Their mean age was 30 years (SD 5). Most women had relapsing-remitting MS (n=218; 94%), 186 (80%) had no children, and 38 (16%) were pregnant. Internal consistency was good for the worries subscale (CA>0.8), while it was unsatisfactory for the attitude and coping subscales (CA<0.7). The EFA did not support the three-scale structure (coping, attitude, and worries). Due to these findings, we decided to keep the worries scale without any subscale. The items from the coping scale and attitude scale could be assessed as additional descriptive items. Convergent and divergent construct validity of the MPWQ was satisfactory. 206 wwMS (89%) completed the MCKQ. On average, 9 of 16 (56%) items were answered correctly (range 2-15), and the questionnaire showed a good balance between easy and difficult items. Questions on immunotherapy, disease activity, and breastfeeding were the most challenging. WwMS were confident in getting pregnant and raising a child (n=222; 96%). Most wwMS were worried about postpartum relapses (n=200; 86%) and the long-term effects of pregnancy on disease evolution (n=149; 64%). About half of the wwMS (n=124; 54%) did not know where to find professional help and 127 (55%) had no strategies to cope with future impairments so that they could take care of a child. Our results support the suitability and acceptability of both questionnaires as potential patient-reported measures for assessment of knowledge and worries around motherhood/pregnancy in MS. The survey results highlight the need for evidence-based information on motherhood in MS to increase knowledge, reduce worries and support wwMS in making informed decisions.

Polish Adaption of Pregnancy-Related Anxiety Questionnaire - Revised 2 (PRAQ-R2).

To create a Polish adaption of the Pregnancy-Related Anxiety Questionnaire - Revised 2 (PRAQ-R2), which is widely used abroad. PRAQ-R2 was translated into Polish by independent bilingual speakers. Fortyeight pregnant women completed our survey containing the Polish version of PRAQ-R2, Hospital Anxiety and Depression Scale - Modified (HADS-M), and a short sociodemographic questionnaire. After a week, they were asked to complete the PRAQ-R2 questionnaire again. Parametric statistics were used to assess psychometric properties. Our study has shown a good test-retest correlation of 0.70. Participants completed the survey twice (in t1 and after one week - in t2). Cronbach's alpha was calculated as 0.847 at t1 and 0.895 at t2. There was a moderate correlation between PRAQ-R2 at both time points and the HADS-M scale and its subscales. Our Polish adaption of PRAQ-R2 has shown good validity and reliability. It has good internal consistency. Moderate correlation with HADS-M proves that pregnancyrelated anxiety (PrA) is a distinctive disorder from generalized anxiety disorder and depressive disorder. Given the great frequency and the burden of PrA, we believe that PRAQ-R2 should be routinely used among physicians working with pregnant patients.

Mental health issues in antenatal women with prior adverse pregnancy outcomes: Unmasking the mental anguish of rainbow pregnancy.

Mental health issues in pregnancy have adverse implications on the quality of life, however still they go unevaluated and underreported. Women with previous history of abortions or stillbirth may have a higher risk of experiencing mental health problems. The present investigation was aimed to study the prevalence of depression, anxiety, stress and domestic violence in antenatal women with prior pregnancy losses and the need for interventions to treat the same. One hundred pregnant women with a history of prior pregnancy losses (group 1) and 100 women without obstetrical losses (group 2) were enrolled in this cross-sectional study carried out in a tertiary care hospital in India. Women were screened for depression, anxiety, stress and domestic violence using various questionnaires: EPDS (Edinburgh postnatal depression scale), PRAQ-2 (pregnancy-related anxiety questionnaire-revised 2), GAD 7 (generalized anxiety disorder-7) and PSS (perceived stress scale). The prevalence of depression (EPDS scale) and pregnancy specific anxiety (PRAQ-2 scale) was significantly higher in group 1 than in group 2 (27 vs. 10%, P=0.008; and 15 vs. 6%, P=0.03). The prevalence of general anxiety (GAD 7 scale) and stress (PSS), however, was high and comparable in both the groups (33 vs. 29%, P=0.44; and 33 vs. 27%; P=0.35 respectively). Recurrent abortions was found to be an independent risk factor for depression [adjusted odds ratio=26.45; OR=28]. In group 1, 31 per cent required counselling in the psychiatry department and nine per cent required medication. Mental health issues, especially depression, are prevalent in antenatal women with previous losses. Unrecognised and untreated, there is a need for counselling and developing screening protocols at India's societal and institutional levels.

Pregnancy-Related Anxiety and Prenatal Attachment in Pregnant Women with Preeclampsia and/or Gestational Diabetes Mellitus: A Cross-Sectional Study

Objective: Health problems experienced during pregnancy may increase anxiety level during pregnancy and affect motherbaby attachment. The present study aimed to compare pregnancy-related anxiety and prenatal attachment levels between low-risk pregnant women and pregnant women with preeclampsia and/or gestational diabetes mellitus (GDM). Material and Methods: One hundred fifty women were recruited in this cross-sectional descriptive study (55 preeclampsia and/or GDM, 95 low-risk) pregnant women. Data were collected using descriptive data form, Pregnancy-Related Anxiety Questionnaire-Revised-2 (PRAQ-R2), and Prenatal Attachment Scale (PAS). Results: Prenatal attachment scores of the working pregnant women in the low-risk group were higher than those in the non-working pregnant women (p0.05). Conclusion: In line with the study results, it was found that low-risk and working pregnant women had higher prenatal attachment levels. Levels of prenatal attachment were higher in primiparous pregnant women in the high-risk group. As pregnancyrelated anxiety levels of high-risk and healthy pregnant women increased, concern about one's own appearance scores increased. Therefore, reducing anxiety levels of pregnant women during pregnancy may be an effective intervention in reducing concerns about their appearance.

Psychometric evaluation of the pregnancy-related anxiety questionnaire—revised 2 for Chinese pregnant women

IntroductionPregnancy related anxiety (PrA) is a unique type of anxiety during pregnancy. PrA can affect both maternal and infant health, as well as pregnancy outcomes. The purpose of this study was to culturally translate the Pregnancy-Related Anxiety Questionnaire—Revised 2 (PRAQ-R2) into Chinese and evaluate its psychometric properties in Chinese women during pregnancy irrespective of parity. MethodsThere were 411 Chinese pregnant women recruited from September 2020 to June 2021. The Cronbach's alpha, split-half reliability, and test-retest reliability were used to evaluate the reliability of PRAQ-R2 Chinese version. Validity was analyzed through content validity, convergent validity, discriminant validity and construct validity. ResultsThe Chinese version of PRAQ-R2 showed good reliability and validity. The Cronbach's alpha coefficients of the total scale and subscales were all greater than 0.7. The median score (interquartile range, IQR) of PRAQ-R2 was 27 (32, 22). The correlation coefficient between item and hypothesis subscale were all greater than 0.40, indicating good convergence validity. Our findings revealed three dimensions of this scale by exploratory factor analysis and confirmed the original version of PRAQ-R2: worries about bearing a handicapped child, concern about own appearance, and fear of giving birth, with a total variance of 72.84% explained. The confirmatory factor analysis showed accepted model fit indexes. LimitationsAll pregnant women were recruited from one region in China, and the study lacked the longitudinal design. Future longitudinal multi-central studies are needed. Conclusion: The Chinese version of PRAQ-R2 can be used as a promising tool to measure PrA in Chinese pregnant women without comorbidities and complications.

Anxiety during the pregnancy and affecting factors: a cross-sectional study.

Studies have shown that anxiety in the perinatal period leads to preterm birth and negatively affects mother and fetus. Understanding prenatal anxiety and associated factors may help develop screening strategies to identify high-risk women needing intervention during pregnancy. The aim of this study is to determine the pregnancy-related, state, and trait anxiety in the prenatal period and affecting factors. This descriptive study was conducted with 203 pregnant women between May 20 and November 30, 2019. Data were collected using socio-demographic and obstetrics characteristics data collection form, Pregnancy-Related Anxiety Questionnaire-Revised-2 (PRAQ-R2), and State-Trait Anxiety Inventory-I and II (STAI-I and STAI-II). We found statistically significant correlations between age, employment, and parity with fear of giving birth subscale of PRAQ-R2. Pregnant women's mean scale scores were 35.42 ± 9.11 for STAI-I, 42.21 ± 8.21 for STAI-II, and 25.63 ± 8.58 for PRAQ-R2. We found a positive correlation between PRAQ-R2 scale scores and STAI-I, STAI-II scale scores of pregnant women. Age, parity, income, planning status of the pregnancy, and employment status affected the anxiety levels of pregnant women. Assessing the anxiety with multiple validated tools helps clarify the cause of the anxiety and allows to plan appropriate interventions.

Transcranial Electrical Stimulation for Relief of Peripartum Mental Health Disorders in Women Undergoing Cesarean Section With Combined Spinal-Epidural Anesthesia: A Pilot Randomized Clinical Trial.

ObjectiveThis study aimed to explore transcranial electrical stimulation (tES) to relieve peripartum anxiety and depressive symptoms in women undergoing cesarean section with combined spinal–epidural anesthesia.MethodsThis double-blind, randomized, sham-controlled trial was conducted in the Affiliated Hospital of Xuzhou Medical University from March 2021 and May 2021. One hundred and forty-eight full-term parturients giving birth by elective cesarean section were selected, and 126 were included in the intent-to-treat analysis. Parturients were provided standardized anesthesia and randomized to the active-tES (a-tES) group and sham-tES group. Parturients and outcome assessors were blinded to treatment allocation. The primary outcome was the changes in peripartum mental health disorders, including anxiety, assessed by the Pregnancy-Related Anxiety Questionnaire-Revised 2 (PRAQ-R2). Secondary outcomes included peripartum depressive symptoms, assessed by the Edinburgh Postnatal Depression Scale (EPDS), maternal satisfaction, fatigue level, sleep quality index, and pain score during and after operation. Data were collected before entering the operating room (T0), between post-anesthesia and pre-surgery (T1), before leaving the operating room (T2), and at 24 h post-surgery (T3).ResultsOne hundred and twenty-six eligible parturients were enrolled in the two groups: a-tES group (N = 62) and sham-tES group (N = 64). Treatment with tES resulted in significantly lower scores of anxiety compared with sham-tES (T2: P < 0.001; T3: P = 0.001). Moreover, the a-tES groups showed a significant reduction in depression scores (T2: P = 0.003; T3: P = 0.032).ConclusionIn this randomized pilot study, tES treatment is efficacious in alleviating peripartum anxiety and depressive symptoms in women undergoing cesarean section and has been demonstrated to be a novel strategy for improving peripartum mental health disorders.Clinical Trial Registration[www.chictr.org.cn], identifier [ChiCTR2000040963].

Factors Affecting Primiparous Women’s Breastfeeding Self-Efficacy Levels

IntroductionThe aim of this study is to reveal the factors affecting primiparous pregnant women’s breastfeeding self-efficacy levels. This is a descriptive correlational study.MethodThe sample included 512 primiparous pregnant women. A personal information form, the Prenatal Breastfeeding Self-Efficacy Scale (PBSES), the Multidimensional Scale of Perceived Social Support (MSPSS) and the Pregnancy-Related Anxiety Questionnaire–Revised (PRAQ-R2) were used for data collection.ResultsThe pregnant women’s mean total PBSES scores were found to differ significantly based on their descriptive and obstetric characteristics. There was a positive correlation between their mean PBSES scores and their MSPSS total and subscale mean scores. Additionally, there was a negative correlation between the participants’ mean total PBSES scores and their mean total PRAQ-R2 and “concern about own appearance” subscale scores. Place of residence for the longest time, pregnancy risk group, folic acid use before pregnancy, perceived family support, perceived support from friends and concern about own appearance were significant factors in explaining the variance in the pregnant women’s PBSES total scores.DiscussionBoth descriptive and obstetric characteristics of the primiparous pregnant women affected their breastfeeding self-efficacy levels. Social support was also determined to affect the participants’ breastfeeding self-efficacy levels positively, and whereas anxiety affected these levels negatively.

The influence of maternal psychological distress on the mode of birth and duration of labor: findings from the FinnBrain Birth Cohort Study

Antepartum depression, general anxiety symptoms, and pregnancy-related anxiety have been recognized to affect pregnancy outcomes. Systematic reviews on these associations lack consistent findings, which is why further research is required. We examined the associations between psychological distress, mode of birth, epidural analgesia, and duration of labor. Data from 3619 women with singleton pregnancies, from the population-based FinnBrain Birth Cohort Study were analyzed. Maternal psychological distress was measured during pregnancy at 24 and 34 weeks, using the Pregnancy-Related Anxiety Questionnaire-Revised 2 (PRAQ-R2) and its subscale “Fear of Giving Birth” (FOC), the anxiety subscale of the Symptom Checklist-90 (SCL-90) and the Edinburgh Postnatal Depression Scale (EPDS). Mode of birth, epidural analgesia, and labor duration were obtained from the Finnish Medical Birth Register. Maternal psychological distress, when captured with PRAQ-R2, FOC, and SCL-90, increased the likelihood of women having an elective cesarean section (OR: 1.04, 95% CI 1.01–1.06, p = .003; OR: 1.13, 95% CI 1.07–1.20, p < .001; OR: 1.06, 95% CI 1.03–1.10, p = .001), but no association was detected for instrumental delivery or emergency cesarean section. A rise in both the PRAQ-R2, and FOC measurements increased the likelihood of an epidural analgesia (OR: 1.02, 95% CI 1.01–1.03, p = .003; OR: 1.09, 95% CI 1.05–1.12, p < .001) and predicted longer second stage of labor (OR: 1.01, 95% CI 1.00–1.01, p = .023; OR: 1.03, 95% CI 1.02–1.05, p < .001). EPDS did not predict any of the analyzed outcomes. The results indicate that maternal anxiety symptoms (measured using PRAQ-R2, FOC, and SCL-90) are associated with elective cesarean section. Psychological distress increases the use of epidural analgesia, but is not associated with complicated vaginal birth.

Impact of urinary incontinence on anxiety status during pregnancy: A prospective case–control study

ObjectivesTo evaluate the impact of the presence and severity of urinary incontinence (UI) on pregnancy-related anxiety. Study designThis prospective case–control study included 160 pregnant women. Pregnant women with UI (n = 80) were compared with continent pregnant women (n = 80; control group) in terms of scores on the Incontinence Consultation Questionnaire-Short Form (ICIQ-SF) and the Pregnancy-related Anxiety Questionnaire-Revised 2 (PRAQ-R2) scale. Gynaecological examination was performed, and pelvic organ prolapse was diagnosed using the Pelvic Organ Prolapse Quantification system. UI was classified as stress UI (SUI), urge UI (UUI) or mixed UI (MUI). ResultsThe total PRAQ-R2 score was significantly higher in all pregnant women with UI, as well as the UI subgroups, compared with the control group [mean ± standard deviation; 21.77 ± 8.1 (UI), 19.39 ± 6 (SUI), 20.13 ± 7.2 (UUI) and 28.1 ± 9.5 (MUI) vs 15.76 ± 5.9 (control group); p < 0.0001, p = 0.002, p = 0.012 and p < 0.0001, respectively). Significant positive correlation was found between the total ICIQ-SF and total PRAQ-R2 scores (r = 0.533; p < 0.0001). The score for the fear of giving birth domain in PRAQ-R2 was higher in women with SUI and MUI compared with the control group (9.5 ± 4 and 11.1 ± 2.6 vs 5.43 ± 2.4; p < 0.0001). Concern about own appearance was greater in the UUI and MUI groups compared with the control group (9.68 ± 4.5 and 7.8 ± 3.1 vs 4.85 ± 2.3; p < 0.0001). ConclusionTo the authors’ knowledge, this is the first study to report the impact of the presence and severity of UI on pregnancy-related anxiety. The current findings show that anxiety may be an important psychosocial consequence of UI in pregnancy. This may lead to a clinical approach focusing on both the physical and psychological well-being of pregnant women with UI.

Sex-specific associations between maternal pregnancy-specific anxiety and newborn amygdalar volumes - preliminary findings from the FinnBrain Birth Cohort Study

Previous literature links maternal pregnancy-specific anxiety (PSA) with later difficulties in child emotional and social cognition as well as memory, functions closely related to the amygdala and the hippocampus. Some evidence also suggests that PSA affects child amygdalar volumes in a sex-dependent way. However, no studies investigating the associations between PSA and newborn amygdalar and hippocampal volumes have been reported. We investigated the associations between PSA and newborn amygdalar and hippocampal volumes and whether associations are sex-specific in 122 healthy newborns (68 males/54 females) scanned at 2–5 weeks postpartum. PSA was measured at gestational week 24 with the Pregnancy-Related Anxiety Questionnaire Revised 2 (PRAQ-R2). The associations were analyzed with linear regression controlling for confounding variables. PSA was associated positively with left amygdalar volume in girls, but no significant main effect was found in the whole group or in boys. No significant main or sex-specific effect was found for hippocampal volumes. Although this was an exploratory study, the findings suggest a sexually dimorphic association of mid-pregnancy PSA with newborn amygdalar volumes.

Correlation of Anxiety with Pregnancy Symptoms and Maternal-Fetal Attachment

Background: Anxiety during pregnancy may affect maternal-fetal attachment (MFA) and the prevalence of pregnancy symptoms. Objectives: The present study aimed to assess the correlation of anxiety with pregnancy symptoms and MFA. Methods: This cross-sectional study was conducted on 220 pregnant women in the health centers of Tabriz, Iran, in 2020. Samples were selected by the cluster sampling method. Data were collected using the socio-demographic questionnaire, Pregnancy-related Anxiety Questionnaire-revised 2 (PRAQ-R2), MFA Scale (MFAS), and Pregnancy Symptoms Inventory (PSI), all of which were completed as self-administered in the second half of pregnancy. The Pearson's correlation coefficient and adjusted general linear model were used for data analysis. Results: The results of Pearson's correlation showed no correlation between anxiety during pregnancy and MFA among nulliparous (r = -0.003, P = 0.976) and multiparous (r = -0.003, P = 0.712) pregnant women. However, anxiety and pregnancy symptoms were significantly correlated among nulliparous (r = 0.424, P &lt; 0.001) and multiparous (r = 0.227, P = 0.028) pregnant women. According to the general linear model, after adjusting the socio-demographic variables, a significant correlation was observed between anxiety and pregnancy symptoms (P &lt; 0.001), while no relationship was found between anxiety and MFA (P = 0.705). Conclusions: Given the significant correlation between anxiety and pregnancy symptoms, pregnant women with anxiety symptoms need to be screened and treated by an expert psychological team if their disorder is confirmed.

Pregnancy-Related Anxiety and Impact of Social Media Among Pregnant Women Attending Primary Health Care.

BackgroundPregnant women go through physiological as well as psychological changes during pregnancy. Antenatal anxiety disorders are common, with proven adverse maternal and fetal outcomes. Anxiety increases the risks for prematurity and neurodevelopmental disorders. This study aimed to estimate the prevalence of pregnancy-related anxiety and the impact of social media among pregnant women in Al-Ahsa, Saudi Arabia.Materials and methodsThis observational cross-sectional study included pregnant women who were attending antenatal care (ANC) in primary healthcare centers between May and October of 2021 in Al-Ahsa, Saudi Arabia. For data collection, a structured self-administered questionnaire was distributed randomly to eligible pregnant women. The presence of pregnancy-related anxiety was assessed by using the 10-item Pregnancy-Related Anxiety Questionnaire-Revised (PRAQ-R), Arabic version. The impact of social media was measured through Social Media Engagement Questionnaire (SMEQ).ResultsOut of 823 pregnant women, 382 were eligible. Their mean age was 26.1 ± 10.9 years. Most of them (70.4%) had adhered to ANC. However, 32.1% had a history of miscarriage, and 6.7% had previous birth with congenital anomalies. The mean scores of pregnancy-related anxiety domains were 10.6 out of 15 for fear of giving birth, 8.7 for concern of own appearance, and 6.4 out of 12 for worries about bearing a handicapped child. More than half of the participants scored 28 out of 50 for pregnancy-related anxiety. The factors that were significantly associated with pregnancy-related anxiety were healthcare workers, first trimester, and unplanned pregnancy (P < 0.05). Social media engagement showed no correlation with anxiety.ConclusionsThe pregnancy-related anxiety level was average among pregnant women in Al-Ahsa, and fear of giving birth was the most common reason. Its predictors included early pregnancy, being a healthcare provider, and unplanned pregnancy. Pregnancy-related anxiety should be diagnosed early during routine ANC for better maternal and fetal outcomes.