Predictors and Correlates of Anxiety in Women Hospitalized With High-Risk Pregnancy

Anxiety during pregnancy often negatively impacts a woman's perception of her pregnancy, as well as affects the development of the fetus and contributes to long-term negative sequelae during subsequent years post-delivery. Despite the increases in attention to the effects of anxiety in the perinatal literature, few studies utilize women with high-risk pregnancy as their population of study. These women would appear to be at a greater risk of experiencing anxiety because of the physical and psychological demands of their complicated pregnancies. Therefore, the current study attempted to determine the demographic and psychosocial correlates of anxiety in this unique population. This investigation also sought to improve significant methodological limitations found in previous published reports by employing a "gold standard" clinical diagnostic interview in addition to self-report measures of anxiety. Finally, this study examined the course of anxiety across hospitalization. From October 2005 to December 2006, 129 participants admitted to a high-risk antenatal unit participated in this investigation. Of those participants, 12% were diagnosed with an anxiety disorder. This prospective investigation revealed significant associations among anxiety symptoms and younger maternal age, lower education and income level, and Medicaid insurance status. Further multivariate analyses revealed that relationship maladjustment, greater number of and elevated perceived distress of stressful life events, and the consideration of termination were also significantly associated with the presence of anxiety symptoms. Logistic regression analyses determined that endorsed depressive symptoms predicted more than a one-and-a-half time's likelihood of increased anxiety symptoms. These findings show that anxiety symptoms are present in women hospitalized with high-risk pregnancy and directly impact the experience of pregnancy. These results demonstrate that identifying potential risk factors of anxiety through routine screenings at initial admission could lead to the development of hospital-based short-term interventions aimed at preventing negative antenatal and postpartum outcomes.