Pregnancy-Related Anxiety Questionnaire Research Articles

Étude de l’anxiété liée à la grossesse et de la peur d’accouchement et de leurs facteurs associés

Pregnancy and childbirth are periods of major transition characterized by physical, biological, and psychological disruptions that can affect women's mental health. Women are particularly vulnerable to a large variety of anxiety disorders such as tocophobia and pregnancy-related anxiety. Our study aimed to assess the intensity of pregnancy-related anxiety and fear of childbirth during the 3rd trimester of pregnancy, to identify associated factors, and to investigate the relationship between pregnancy-related anxiety, fear of childbirth, marital satisfaction, and social support. Our study was carried on in the gynecology and obstetrics department of the Hedi Chaker Hospital in Sfax – Tunisia from 22 February 2023 to 31 July 2023. To assess pregnancy-related anxiety and fear of childbirth, we used the Pregnancy-related anxiety questionnaire and the Fear of Childbirth Scale, respectively. Social support and marital satisfaction were assessed using the Social Provisions Scale and the Azrin Scale. We enrolled 350 women with a mean age of 29.3 years. In 53.7% of cases, they had not completed secondary school and in 60.9% of cases, they were housewives. In the assessment of marital satisfaction based on the AZRIN score, 38.8% of women had good marital satisfaction (score above 6), 20.9% had poor satisfaction (score below 5) and 40.3% had average satisfaction (score between 5 and 6). Social support scores ranged from 14 to 40, with an average of 30.22 and a standard deviation of 4.66. The mean score for anxiety related to pregnancy was 31.24 and 48.7 for fear of childbirth. Pregnancy-related anxiety and fear of childbirth were positively and strongly correlated. In multivariate analysis, the independent factors associated with pregnancy-related anxiety and fear of childbirth were a negative experience during the last childbirth, episiotomy, lack of information before episiotomy, and intense sympathetic signs. Sufficient psychological support from the health care team was a protective factor against the fear of childbirth. Marital satisfaction and perceived social support were weakly and negatively correlated with pregnancy-related anxiety and fear of childbirth. Birth preparation and marital and social support are the cornerstones of a pregnant woman's well-being.

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

The Effects of Emotional Freedom Techniques Implemented During Early Pregnancy on Nausea-Vomiting Severity and Anxiety: A Randomized Controlled Trial.

Objective: This randomized controlled trial investigated the effect of emotional freedom techniques (EFT) on the severity of nausea-vomiting and anxiety in early pregnancy. Design: The sample consisted of 131 pregnant women in the experimental and control groups between 6 and 16 weeks of pregnancy attending an antenatal clinic. Participants were randomly assigned to receive training on EFT or a control group. Data were collected using a personal information form, subjective experiences, the Pregnancy-Related Anxiety Questionnaire, and the Pregnancy-Unique Quantification of Emesis. Both groups attended two visits, a week apart. The participants in the EFT group received a session of EFT at each visit and completed two EFT sessions as home assignments, 2 and 4 days after the first visit. The participants in the control group attended two visits a week apart and completed assessments but did not receive EFT. Results: There were 55 women in each group who completed the study, and the groups were similar in terms of baseline measures, including socioeconomic status, smoking status, previous pregnancy, severity of nausea-vomiting, and total pregnancy-related anxiety. EFT significantly reduced anxiety levels from the baseline to the second session (fear of delivery, worries about bearing a handicapped child, concern about one's own appearance) and total pregnancy-related anxiety (total pretest 29.85 ± 9.87, post-test 20.67 ± 8.38; p < 0.001), while the control group showed no reduction in pregnancy-related anxiety (total pretest 26.1 ± 7.79, post-test 25.98 ± 8.49; p = 0.933). Although nausea-vomiting was reduced in both groups over the two-session period, at the end of treatment, the EFT group had significantly lower nausea intensity (EFT group 4.4 ± 1.81, control group 5.36 ± 2.48; p = 0.02). Conclusions: EFT is a nonpharmacologic intervention that can be effective in reducing nausea, vomiting, and anxiety in early pregnancy. Clinical Trials Registration Number: NCT05337852.

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.

Anxiety, prenatal distress, and resilience during the first trimester of gestation.

To describe and analyze the relationship between pregnancy-related anxiety, prenatal distress, and individual resilience in pregnant women during the first trimester of pregnancy and compare it with the obstetric variable of parity. Quantitative, descriptive, cross-sectional study using non-probabilistic circumstantial sampling. A total of 144 women participated. The Prenatal Distress Questionnaire, the Resilience Scale, and the Pregnancy-Related Anxiety Questionnaire were used. A descriptive analysis with measures of central tendency was performed, and the reliability of the instruments was assessed. The average age was 33.57 years. 58.3% were multiparous and 41.7% primiparous. Anxiety was found in 21.5% and very high levels of resilience in 54.9%. Primiparous women showed higher levels of worry about the future and fear of childbirth than multiparous women. Pregnant women with high resilience showed lower levels of anxiety and stress. Pregnant women with higher levels of resilience show less anxiety and stress during the first trimester of pregnancy. Primiparous women show more anxiety and stress than multiparous women.

Using an Electronic Mindfulness-based Intervention (eMBI) to improve maternal mental health during pregnancy: Results from a randomized controlled trial

Prevalence rates of peripartum depression and anxiety are high and correlate with adverse maternal and neonatal outcomes. Mindfulness-based interventions (MBI) have been shown to reduce mental distress during pregnancy.A multicenter, randomized controlled study was conducted after screening for depressive symptoms. The intervention group (IG) was given access to an 8-week supervised eMBI between weeks 29 and 36 of pregnancy and followed up to 5 months postpartum. Psychometric data were collected using the Edinburgh Postnatal Depression Scale (EPDS), the State-Trait Anxiety Inventory (STAI), the Pregnancy-Related Anxiety Questionnaire (PRAQ-R), the Freiburg Mindfulness Inventory (FMI-14) as well as the Patient Health Questionnaire (PHQ).Out of 5299 pregnant women, 1153 scored >9 on the EPDS and N = 460 were included in the RCT. No significant interaction effects for depressive symptoms and anxiety were found. Pregnancy- and birth-related anxiety decreased significantly in the IG and 6 weeks after birth, the rate of women at risk for adverse mental outcome was significantly lower compared to the CG. Mindfulness scores improved significantly in the IG.The eMBI program did not show effective regarding general depressive or anxiety symptoms, however, positive results were demonstrated regarding pregnancy and birth-related anxiety and the prevention of postpartum depression.

The Effect of Haptonomy Intervention on Fear of Childbirth and Maternal- Fetal Attachment Among Primigravid Women

Background: Fear of childbirth (FOC) is considered as one of the factors influencing the increase of elective cesarean section. The appropriate solution to reduce the FOC has not yet been identified. Objective: The present study aimed to evaluate the effect of haptonomy intervention on FOC and maternal-fetal attachment (MFA) among primigravid women‎. Methods: This quasi-experimental study was conducted on 68 primigravid women with a gestational age of 24-28 weeks who referred to health centers in Tabriz, Iran with a FOC score above 65. Participants were randomly assigned into the intervention and control groups. The intervention group (n=34) received haptonomy in 5 sessions, once a week for 45-60 minutes, and control group received an information pamphlet about pain management options in labor and fetal development during pregnancy. The data were collected using Wijma Delivery Expectancy/Experience Questionnaire-version A, Cranley’s MFA Scale, and Revised Pregnancy Related Anxiety Questionnaire, before the intervention and at gestational age of 35-37 weeks. The data were analyzed using Chi-square, independent t-test, and ANCOVA. Findings: After intervention and controlling the effect of baseline score, the mean score of FOC in the intervention group was significantly lower than that in the control group [Adjusted mean difference (AMD): -23.67, 95% CI: - 28.12 to -19.23, P =0.001]. Further, the mean score of MFA indicated a significant difference between the two groups [AMD: 10.12, 95% CI: 6.44 to 13.8, p &lt;0.001]. Conclusion: The results of the present study revealed the effectiveness of the haptonomy intervention in reducing FOC and increasing MFA. Therefore, the use of haptonomy intervention is recommended among mothers with high and severe FOC and low MFA.

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.

Joint effects of prenatal exposure to air pollution and pregnancy-related anxiety on birth weight: A prospective birth cohort study in Ma’anshan, China

BackgroundA growing number of studies have shown that prenatal exposure to chemical and non-chemical stressors has effects on fetal growth. The co-exposure of both better reflects real-life exposure patterns. However, no studies have included air pollutants and pregnancy-related anxiety (PrA) as mixtures in the analysis. MethodUsing the birth cohort study method, 576 mother-child pairs were included in the Ma'anshan Maternal and Child Health Hospital. Evaluate the exposure levels of six air pollutants during pregnancy using inverse distance weighting (IDW) based on the pregnant woman's residential address and air pollution data from monitoring stations. Prenatal anxiety levels were assessed using the PrA Questionnaire. Generalized linear regression (GLR), quantile g-computation (QgC) and bayesian kernel machine regression (BKMR) were used to assess the independent or combined effects of air pollutants and PrA on birth weight for gestational age z-score (BWz). ResultThe results of GLR indicate that the correlation between the six air pollutants and PrA with BWz varies depending on the different stages of pregnancy and pollutants. The QgC shows that during trimester 1, when air pollutants and PrA are considered as a whole exposure, an increase of one quartile is significantly negatively correlated with BWz. The BKMR similarly indicates that during trimester 1, the combined exposure of air pollutants and PrA is moderately correlated with a decrease in BWz. ConclusionUsing the method of analyzing mixed exposures, we found that during pregnancy, the combined exposure of air pollutants and PrA, particularly during trimester 1, is associated with BWz decrease. This supports the view that prenatal exposure to chemical and non-chemical stressors has an impact on fetal growth.

Self-Efficacy and Anxiety Level of Third-Trimester Primigravida

Childbirth anxiety causes changes in a woman's mind during the third trimester. Prolonged worry can make it difficult for pregnant women to focus and cause them to lose confidence. Purpose: This study determines the relationship between self-efficacy and anxiety levels of third-trimester primigravida pregnant women. Methods: This study used cross-sectional data and correlation analysis. The purposive sampling method selected 82 third-trimester pregnant women as the study population. The study sample included 57 third-trimester pregnant women per the inclusion criteria. This study used two questionnaires: the self-confidence scale and the Revised Pregnancy-Related Anxiety Questionnaire (PRAQ-R2). The research results on self-efficacy obtained 63.2% with moderate self-efficacy, while anxiety levels obtained the majority with moderate anxiety at 49.1%. Data analysis using the Spearman Rank correlation test formula obtained a correlation coefficient of 0.645 with a significance of 0.000 (p &lt;0, 05). Conclusion: There is a significant relationship in the self-efficacy of third-trimester primigravida pregnant women with anxiety levels with a strong correlation coefficient.

Maternal anxiety during pregnancy and children's asthma in preschool age: The Ma'anshan birth cohort study

BackgroundThe fetal immune system and consequent elevated risk of asthma in childhood may be impacted by maternal anxiety during pregnancy. Limited studies have evaluated whether there was a sensitive period and cumulative effect of the relationship between prenatal anxiety and children's asthma. Methods3131 mother-child pairs made up the study's sample from the Ma'anshan Birth Cohort Study in China. Maternal anxiety status was repeated three times using the pregnancy-related anxiety questionnaire in the 1st, 2nd and 3rd trimesters of pregnancy. Diagnostic information on asthma was collected three times at 24, 36, and 48 months of age. ResultsAfter adjusting for confounders, children born to mothers with anxiety in the 1st, 2nd and 3rd trimesters of pregnancy all had an elevated risk of total asthma from 12 to 48 months of age. After further adjusting prenatal anxiety in the other trimesters, no association was observed between prenatal anxiety in any trimester and preschoolers' asthma. Children of mothers with persistently high anxiety score trajectory during pregnancy had an elevated risk of total asthma and high prevalence trajectory of asthma. Cumulative effects analysis showed that the more frequent the mother's anxiety, the higher the risk of her offspring developing a high prevalence trajectory of asthma from 12 to 48 months of age. The results of the subgroup analysis by age showed similar associations overall. ConclusionsMaternal antenatal anxiety was associated with an elevated risk of preschool children's asthma, and a possible cumulative effect was observed. Maternal mental health conditions during pregnancy should receive constant attention throughout pregnancy, not just during one period.

Effects of mindfulness-based childbirth education on prenatal anxiety: A quasi-experimental study

Pregnancy and childbirth represent a sequence of challenging events, and adaptive coping strategies are necessary to maintain emotional wellbeing. The present study aimed to assess the effectiveness of applying a mindfulness-based intervention (MBI) for pregnant Saudi women with anxiety in the third trimester. A quasi-experimental, within- and between-subject design was used for this study. Data were collected at two points between February and August 2021 from 88 participants using the Pregnancy-Related Anxiety Questionnaire and the Five Facet Mindfulness Questionnaire. A large, statistically significant reduction was observed in the mean scores of participants' anxiety post-intervention. Furthermore, the anxiety level in the intervention group was very low post-intervention compared to that in the control group. Level of education and spontaneous or medically necessary abortion significantly influenced participants’ anxiety. The MBI sessions helped nulliparous women experience less anxiety during pregnancy. Healthcare providers' awareness about the importance of incorporating mindfulness in childbirth education should be increased. Future research should examine the long-term effects of mindfulness-based techniques on maternal health.

Development of the Japanese Version of Pregnancy-Related Anxiety Questionnaire-Revised-2: Measurement and Psychometric Properties.

Tools to evaluate pregnancy-specific anxiety are lacking in Japan. This study aimed to develop a Japanese version of the Pregnancy-Related Anxiety Questionnaire-Revised-2. After scale translation and cognitive interviews, we conducted a cross-sectional study among 120 ≥18-year-old, singleton (pregnant with one baby) Japanese women before 15 weeks of pregnancy, recruited from four facilities. A total of 112 women completed the questionnaires. We tested the internal consistency, measurement error and reliability, structural validity, measurement invariance across nulliparous and parous women, construct validity by calculating omega, standard error of measurement (SEM), intraclass correlation coefficient (ICC), confirmatory factor analysis (CFA), multigroup CFA, multitrait-scaling analysis, correlational analyses with other measurements, and t-test to compare nulliparous and parous groups. Omega was 0.90 for the total score. SEM was 3.4 and ICC was 0.76. The CFA revealed an optimal fit for the three-factor model based on the original scale. Multigroup CFA supported measurement invariance across the nulliparous and parous groups, and multitrait-scaling analysis revealed 100% scaling success. The correlation coefficients with other scales of childbirth anxiety and general anxiety were 0.70 and 0.24. The mean total score of the nulliparous women was higher than that of the parous women (34.5 vs. 30.3, p = 0.001). Therefore, the scale was determined to have good validity and reliability.

Maternal pregnancy-related anxiety and children’s physical growth: the Ma’anshan birth cohort study

BackgroundEpidemiological studies have identified maternal antenatal anxiety and several adverse birth outcomes, but limited studies have focused on the relationship with the long-term physical growth of children. The study aimed to assess the influence of maternal pregnancy-related anxiety on physical growth in children at different exposure periods during pregnancy.Methods3,154 mother-child pairs were included based on the Ma’anshan birth cohort study. Maternal prenatal anxiety was obtained by administering a questionnaire using the pregnancy-related anxiety questionnaire (PRAQ) scale during the 1st, 2nd and 3rd trimesters of pregnancy. Body fat (BF) (48 to 72 months) and Body Mass Index (BMI) (birth to 72 months) were collected repeatedly for children. Group-based trajectory models were applied to fit the different trajectories of BMI and BF.ResultsMaternal anxiety in the 2nd (OR = 0.81; 95% CI: 0.68 to 0.98; P < 0.025) and 3rd (OR = 0.80; 95% CI: 0.67 to 0.97; P = 0.020) trimesters was associated with a decreased risk of rapid weight gain (RWG) in the first year of life. Children aged 48 to 72 months of mothers with anxiety in the 3rd trimester had lower BMI (β = -0.161; 95% CI, -0.293 to -0.029; P = 0.017) and BF (β = -0.190; 95% CI, -0.334 to -0.046; P = 0.010), and these children were less likely to develop a very high BMI trajectory (OR = 0.54; 95% CI: 0.34 to 0.84; P = 0.006), and a high BF trajectory (OR = 0.72; 95% CI: 0.53 to 0.99; P = 0.043). Similar associations were found between maternal anxiety in both 2nd and 3rd trimesters and children’s physical growth.ConclusionsOffspring of mothers with prenatal anxiety in the 2nd and 3rd trimesters predicts poorer growth in infancy and preschool age. Early improvement and treatment of prenatal anxiety could benefit physical health and development in early childhood.

Interaction between isolated maternal hypothyroxinemia and pregnancy-related anxiety on preschooler’s internalizing and externalizing problems: A birth cohort study

BackgroundIsolated maternal hypothyroxinemia (IMH) and pregnancy-related anxiety may increase the risk of offspring’s emotional and behavioral problems, but little is known about their potential interactive effect on preschoolers’ internalizing and externalizing problems. MethodsWe conducted a large prospective cohort study in Ma’anshan Maternal and Child Health Hospital between May 2013 and September 2014. There were a total of 1372 mother-child pairs from the Ma’anshan birth cohort (MABC) included in this study. IMH was defined as the thyroid-stimulating hormone (TSH) level within the normal reference range (2.5–97.5th percentile) and the free thyroxine (FT4) level below the 2.5th percentile, and negative TPOAb. The pregnancy-related anxiety questionnaire (PRAQ) was used to assess women’s pregnancy-related anxiety status in the first (1–13 weeks), second (14–27 weeks) and third (after 28 weeks) trimesters of pregnancy. The Achenbach Child Behavior Checklist (CBCL/1.5–5) was used to assess preschoolers’ internalizing and externalizing problems. ResultsPreschoolers born of mothers with IMH and anxiety had an increased risk of anxious/depressed (OR = 6.40, 95% CI 1.89–21.68), somatic complaints (OR = 2.69, 95% CI 1.01–7.20), attention problems (OR = 2.95, 95% CI 1.00–8.69) and total problems (OR = 3.40, 95% CI 1.60–7.21). Particularly, mothers with IMH and anxiety was associated with an increased risk of preschool girls’ anxious/depressed (OR = 8.14, 95% CI 1.74–38.08), withdrawn (OR = 7.03, 95% CI 2.25–21.92), internalizing problems (OR = 2.66, 95% CI 1.00–7.08), and total problems (OR = 5.50, 95% CI 2.00–15.10). ConclusionsIMH and pregnancy-related anxiety during pregnancy may synergistically increase the risk of internalizing and externalizing problems in preschooler children. This interaction is distinct in internalizing problems of preschool girls.

Effects of 3D-Printed Models and 3D Printed Pictures on Maternal– and Paternal–Fetal Attachment, Anxiety, and Depression

ObjectiveTo compare the effect of a 3D-printed model versus 3D printed pictures on maternal– and paternal–fetal attachment, pregnancy-related anxiety, and depression in parents in the third trimester. DesignRandomized controlled trial. SettingUniversity- and clinic-affiliated hospital system. ParticipantsBetween August 2020 and July 2021, we screened 419 women for eligibility. A total of 184 participants (n = 95 women and n = 89 men) were included in the intention-to-treat analysis, of whom 47 women and 44 men received the 3D-printed model, whereas 48 women and 45 men received the 3D printed picture. MethodsParticipants completed a set of questionnaires before they received third trimester 3D ultrasonography and a second set of questionnaires approximately 14 days after the study ultrasonography. The primary outcome was the global Maternal and Paternal Antenatal Attachment scale scores. Secondary outcomes included the Maternal and Paternal Antenatal Attachment subscale scores, global Generalized Anxiety Disorder–7 scores, global Patient Health Questionnaire–9 scores, and global Pregnancy-Related Anxiety Questionnaire–Revised (second version) scores. We used multilevel models to estimate the effect of the intervention. ResultsWe found a statistically significant increase in mean attachment scores after the 3D printed picture and 3D-printed model intervention of 0.26, 95% confidence interval (CI) [0.22, 0.31], p < .001. Additionally, we found statistically significant improvement in depression (mean change = –1.08, 95% CI [–1.54, –0.62], p < .001), generalized anxiety (mean change = –1.38, 95% CI [–1.87, –0.89], p < .001), and pregnancy-related anxiety (mean change = –2.92, 95% CI [–4.11, –1.72], p < .001) scores. We found no statistically significant between-group differences related to maternal or paternal attachment, anxiety, depression, or pregnancy-related anxiety. ConclusionsOur findings support the use of 3D printed pictures and 3D-printed models to improve prenatal attachment, anxiety, depression, and pregnancy-related anxiety.

Integration of multiomics with precision nutrition for gestational diabetes: Study protocol for the Westlake Precision Birth Cohort

Integration of multiomics with precision nutrition for gestational diabetes: Study protocol for the Westlake Precision Birth Cohort

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.

Efektivitas Diaphragm Breathing Exercise Terhadap Tingkat Kecemasan Ibu Hamil Trimester III di Praktik Mandiri Bidan Kota Padang

The anxiety rate in pregnant women in Indonesia is quite high, namely 28.7% of which this anxiety is experienced by pregnant women in the third trimester before the delivery process. This has an impact on the physical, psychological and process conditions that will be undertaken by the mother, but it also affects the postpartum period. Diaphragm breathing exercise is one of the complementary therapies to overcome the anxiety experienced by pregnant women who have little risk. To determine the effectiveness of diaphragm breathing exercise on the anxiety level of pregnant women in the third trimester. Research Methods: This type of quantitative research uses a quasi-experimental method with one group pretest and posttest design. A total of 16 pregnant women TM III in Padang City Midwives Independent Practice were taken using purposive sampling technique. The measuring instrument used is the PRAQ-R2 (Pregnancy Related Anxiety Questionnaire- Revised) instrument. The effectiveness of the diaphragm breathing exercise on the anxiety of pregnant women with TM III was tested using Paired t-test with p-value &lt; 0.05. Results: The results showed that the average level of maternal anxiety before the intervention was 29.68 and after giving diaphragm breathing exercise the anxiety level was 19.12 with an average difference of 10.56. The results of statistical tests showed that there was a significant effect between the anxiety level of pregnant women with TM III before and after being given diaphragm breathing exercise with a p value of 0.000 (p value &lt;0.05). Conclusion: diaphragm breathing exercise is effective in reducing anxiety levels of pregnant women with TM III in the Independent Practice of Midwives in Padang City.

The role of methylation of placental glucocorticoid response gene in the association between pregnancy-related anxiety in the third trimester and birth outcomes

Objective: To investigate the role of methylation of placental glucocorticoid response gene in the association between pregnancy-related anxiety in the third trimester and birth outcomes. Methods: Based on a prospective cohort study, singleton live births and their mothers from the Ma'anshan Birth Cohort Study (MABC) were included as participants in this study. The maternal pregnancy-related anxiety symptoms in the third trimester of pregnancy were evaluated by using the Pregnancy-related Anxiety Questionnaire. The neonatal birth outcomes were collected from medical records. The placental tissues from 300 pregnant women with pregnancy-related anxiety and 300 without pregnancy-related anxiety were collected to detect the methylation of FKBP5, NR3C1 and HSD11B2 genes using the Methyl Target approach. The methylation factors were extracted by exploratory factor analysis. Linear regression or logistic regression models were used to analyze the association between pregnancy-related anxiety in the third trimester, methylation factor scores, and birth outcomes. The mediating role of methylation factors in the association between pregnancy-related anxiety in the third trimester and birth outcomes was analyzed by using the Process procedure. Results: The mean age of 2 833 pregnant women was (26.60±3.60) years old. After adjusting for confounding factors, pregnancy-related anxiety in the third trimester increased the risk of small-for-gestational-age (OR=1.32, 95%CI:1.00-1.74). A total of 5 methylation factors were extracted, and the factor 5 was loaded with FKBP5 CpGs 18-21. Pregnancy-related anxiety in the third trimester was negatively correlated with the factor 5 (β=-0.24,95%CI:-0.44--0.05). The factor 5 was positively correlated with the gestational age (β=0.17, 95%CI:0.06-0.27). In addition, the factor 2 (β=0.02,95%CI:0.00-0.04) and factor 3 (β=0.03,95%CI:0.01-0.05) were positively correlated with 5-min Apgar score after delivery. However, this study did not found the mediating role of the scores of the factor characterized by FKBP5 in the relationship between pregnancy-related anxiety and birth outcomes. Conclusion: Pregnancy-related anxiety in the third trimester may reduce the methylation level of FKBP5 CpGs 18-21 in placental tissues and is associated with the risk of small-for-gestational-age.