Previous pregnancy outcomes and subsequent pregnancy anxiety in a Quebec prospective cohort
Article [Accepted Manuscript]
Is part of
Journal of psychosomatic obstetrics and gynecology ; vol. 38, no. 2, pp. 121-132.Publisher(s)
Taylor & FrancisAffiliation
Abstract(s)
Introduction—
Pregnancy anxiety is an important psychosocial risk factor that may be more
strongly associated with adverse birth outcomes than other measures of stress. Better
understanding of the upstream predictors and causes of pregnancy anxiety could help to identify
high-risk women for adverse maternal and infant outcomes. The objective of the present study was
to measure the associations between five past pregnancy outcomes (live preterm birth (PTB), live
term birth, miscarriage at <20 weeks, stillbirth at ≥20 weeks, and elective abortion) and pregnancy
anxiety at three trimesters in a subsequent pregnancy.
Methods—
Analyses were conducted using data from the 3D Cohort Study, a Canadian birth
cohort. Data on maternal demographic characteristics and pregnancy history for each known
previous pregnancy were collected via interviewer-administered questionnaires at study entry.
Pregnancy anxiety for the index study pregnancy was measured prospectively by self-administered
questionnaire following three prenatal study visits.
Results—
Of 2366 participants in the 3D Study, 1505 had at least one previous pregnancy. In
linear regression analyses with adjustment for confounding variables, prior live term birth was
associated with lower pregnancy anxiety in all three trimesters, whereas prior miscarriage was
significantly associated with higher pregnancy anxiety in the first trimester. Prior stillbirth was
associated with greater pregnancy anxiety in the third trimester. Prior elective abortion was significantly associated with higher pregnancy anxiety scores in the first and second trimesters,
with an association of similar magnitude observed in the third trimester.
Discussion—
Our findings suggest that the outcomes of previous pregnancies should be
incorporated, along with demographic and psychosocial characteristics, into conceptual models
framing pregnancy anxiety.
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