Abstract
Many women suffer from new or worsening anxiety during pregnancy. In this pilot study, we investigated the effect of timing and severity of prenatal state anxiety symptoms on reduced birth weight. We hypothesized that: (1) Women with state anxiety symptoms during mid-gestation would deliver newborns with lower birth weight in comparison to participants with symptoms in early gestation and (2) compared to women with lower anxiety symptoms (< 50th percentile), women with medium-to-high state anxiety symptoms (> 50th percentile) would have lower birth weight offspring. The sample consisted of the first 30 pregnant women who agreed to participate in this pilot study. We assessed anxiety symptoms, using the State-Trait Anxiety Inventory during early and mid-gestation. We obtained birth weight from clinical charts. A hierarchical multiple regression showed that, after controlling for covariates, state anxiety symptoms in mid-gestation were associated with lower infant birth weight [F(9, 7) = 20.30, p<.001]. However, birth weight did not differ as a function of the severity of maternal state anxiety [F(1, 23)=.14, p=.71 and F(1, 24)=1.76, p=.20., respectively]. Clearly, our pilot data need replication. Once statistical significance is established with larger samples, it will be informative to examine the clinical significance of those findings.
[1] Catov J.M., Abatemarco D.J., Markovic N., Roberts J.M. Anxiety and optimism associated with gestational age at birth and fetal growth. Matern. Child Health J., 2010, 14, 758–764 http://dx.doi.org/10.1007/s10995-009-0513-y10.1007/s10995-009-0513-ySearch in Google Scholar PubMed PubMed Central
[2] Levin J.S., DeFrank R.S. Maternal stress and pregnancy outcomes: a review of the psychosocial literature. J. Psychosom. Obstetr. Gynaecol., 1988, 9, 3–16 http://dx.doi.org/10.3109/0167482880903094410.3109/01674828809030944Search in Google Scholar
[3] Ross L.E., McLean L.M. Anxiety disorders during pregnancy and the postpartum period: a systematic review. J. Clin. Psychiatry, 2006; 67(8): 1285–1298 http://dx.doi.org/10.4088/JCP.v67n081810.4088/JCP.v67n0818Search in Google Scholar PubMed
[4] Vythilingum B. Anxiety disorders in pregnancy. Curr Psychiatry Rep 2008 Aug; 10(4):331–335 http://dx.doi.org/10.1007/s11920-008-0053-y10.1007/s11920-008-0053-ySearch in Google Scholar PubMed
[5] Hosseini S.M., Biglan M.W., Larkby C., Brooks M.M., Gorin M.B., Day N.L. Trait anxiety in pregnant women predicts offspring birth outcomes. Paediatr. Perinat. Epidemiol., 2009, 23, 557–766 http://dx.doi.org/10.1111/j.1365-3016.2009.01065.x10.1111/j.1365-3016.2009.01065.xSearch in Google Scholar PubMed
[6] Philips D.I.W. Insulin resistance as a programmed response to fetal undernutrition. Diabetol. 1996; 39: 1119–1122 http://dx.doi.org/10.1007/BF0040066310.1007/BF00400663Search in Google Scholar PubMed
[7] Philips DIW. Birth weight and the future development of diabetes. A review of the evidence. Diab. Care, 1998, 21(2), B150–155 Search in Google Scholar
[8] Hocher B. Fetal programming of cardiovascular diseases in later life - mechanisms beyon maternal undernutrition. J. Physiol., 2007, 287–288 10.1113/jphysiol.2007.127738Search in Google Scholar PubMed PubMed Central
[9] Vardavas C.I., Chatzi L., Patelarou E., Plana E., Sarri K., Kafatos A. et al. Smoking and smoking cessation during early pregnancy and its effect on adverse pregnancy outcomes and fetal growth. European Journal of Pediatrics, 2010, 169, 741–748 http://dx.doi.org/10.1007/s00431-009-1107-910.1007/s00431-009-1107-9Search in Google Scholar PubMed
[10] Keegan J., Parva M., Finnegan M., Gerson A., Belden, M. Addiction in pregnancy. Journal of Addictive Diseases, 2010, 29, 175–191 http://dx.doi.org/10.1080/1055088100368472310.1080/10550881003684723Search in Google Scholar PubMed
[11] Raatikainen K., Huurinainen P., Heinonen S. Smoking in early gestation or through pregnancy: a decision crucial to pregnancy outcome. Prev. Med., 2007, 44, 59–63 http://dx.doi.org/10.1016/j.ypmed.2006.07.01710.1016/j.ypmed.2006.07.017Search in Google Scholar PubMed
[12] Visscher W.A., Feder M., Burns A.M., Brady T.M., Bray R.M. The impact of smoking and other substance use by urban women on the birthweight of their infants. Sub. Use Misuse, 2003, 38(8), 1063–1093 http://dx.doi.org/10.1081/JA-12001765110.1081/JA-120017651Search in Google Scholar
[13] Nasreen H.E., Kabir Z.N., Forsell Y., Edhborg, M. Low birth weight in offspring of women with depressive and anxiety symptoms during pregnancy: results from a population based study in Bangladesh. BMC Public Health, 2010, 10 (515 10.1186/1471-2458-10-515Search in Google Scholar PubMed PubMed Central
[14] Sen J., Roy A., Mondal N. Association of maternal nutritional status, body composition and socioeconomic variables with low birth weight in India. J. Trop. Pediatr., 2010, 56(4), 254–259 http://dx.doi.org/10.1093/tropej/fmp10210.1093/tropej/fmp102Search in Google Scholar PubMed
[15] Nepomnyaschy L. Socioeconomic gradients in infant health across race and ethnicity. Matern. Child Health J., 2009, 13, 720–731 http://dx.doi.org/10.1007/s10995-009-0490-110.1007/s10995-009-0490-1Search in Google Scholar PubMed
[16] Najati N., Gojazadeh M. Maternal and neonatal complications in mothers under 18 years. Patient Preference and Adherence, 2010, 4, 219–222 http://dx.doi.org/10.2147/PPA.S1123210.2147/PPA.S11232Search in Google Scholar
[17] Spielberger C.D., Gorsuch R.L., Lushene R.E. Manual for the State-Trait Anxiet Inventory, 1970, Palo Alto, CA: Consulting Psychologists Press Search in Google Scholar
[18] Gauthier J, Bouchard S. Adaptation canadiennefrançaise de la forme révisée du “State-Trait Anxiety Inventory” de Spielberger [French- Canadian adaptation of the revised “State-Trait Anxiety Inventory”]. Can. J. Behav. Science, 1993, 25, 559–578 http://dx.doi.org/10.1037/h007888110.1037/h0078881Search in Google Scholar
[19] Tilton S.R. Review of the state-trait anxiety inventory (STAI). News Notes, 2008, 48(2) Search in Google Scholar
[20] Huang F.Y., Chung H., Kronke K., Delucci K., Spitzer R., Using the Patient Health Questionnaire-9 to Measure Depression among Racially and Ethnically Diverse Primary Care Patients. J. Gen. Intern. Med., 2006, 21(6), 547–552 http://dx.doi.org/10.1111/j.1525-1497.2006.00409.x10.1111/j.1525-1497.2006.00409.xSearch in Google Scholar PubMed PubMed Central
[21] Cohen S., Kamarck T., Mermelstein R. A global measure of perceived stress. Journal of Health and Social Behavior, 2003, 24, 385–396 http://dx.doi.org/10.2307/213640410.2307/2136404Search in Google Scholar
[22] Sewitch M.J., Dobkin P.L., Bernatisky S., Baron M., Starr M., Cohen M., & Fitzcharles, A. Medication non-adherence in women with fibromyalgia. Rheumatol., 2004, 43, 648–654 http://dx.doi.org/10.1093/rheumatology/keh14110.1093/rheumatology/keh141Search in Google Scholar PubMed
[23] Azar R., Paquette D., Zoccolillo M., Baltzer F., Tremblay R.E. The association of major depression, and maternal overcontrol with a failure to show a cortisol buggered response in 4 month-old-infants of teenage mothers. Biol. Psychiatr., 2007, 62, 573–579 http://dx.doi.org/10.1016/j.biopsych.2006.11.00910.1016/j.biopsych.2006.11.009Search in Google Scholar PubMed
[24] Philips D.I.W., Jones A. (2006). Fetal programming of autonomic and HPA function: do people who were small babies have enhanced stress responses? J. Physiol., 572, 45–50 10.1113/jphysiol.2005.104695Search in Google Scholar PubMed PubMed Central
[25] Field T., Diego M., Hernandez-Reif M., Schanberg S., Kuhn C., Yando R. et al. Pregnancy anxiety and comorbid depression and anger: effects on the fetus and neonate. Depr. Anxiety, 2003, 17, 140–151 http://dx.doi.org/10.1002/da.1007110.1002/da.10071Search in Google Scholar PubMed
© 2012 Versita Warsaw
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.