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Schetter CD, Rahal D, Ponting C, Julian M, Ramos I, Hobel C, Coussons-Read M. Anxiety in pregnancy and length of gestation: Findings from the healthy babies before birth study. Health Psychol 2022; 41:894-903. [PMID: 36154104 PMCID: PMC9885848 DOI: 10.1037/hea0001210] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVES Anxiety is prevalent in pregnancy and predicts risk of adverse birth outcomes. Many instruments measure anxiety in pregnancy, some of which assess pregnancy anxiety defined as maternal concerns about a current pregnancy (e.g., baby, childbirth). The present study examined covariance among four anxiety or distress measures at two times in pregnancy and tested joint and individual effects on gestational length. We hypothesized that the common variance of the measures in each trimester would predict earlier delivery. METHOD Research staff interviewed 196 women in first and third trimester utilizing a clinical screener of anxiety severity/impairment, two instruments measuring pregnancy anxiety, and one on prenatal distress. Birth outcomes and medical risk factors were obtained from medical records after birth. Structural equation modeling fit latent factors for each trimester from the four measures. Subsequent models tested whether the latent factors predicted gestational length, and unique effects of each measure. RESULTS The third-trimester pregnancy anxiety latent factor predicted shorter gestational length adjusting for mother's age, education, parity, and obstetric risk. Scores on a four-item pregnancy-specific anxiety measure (PSAS) in third trimester added uniquely to prediction of gestational length. In first trimester, scores on the clinical screener (OASIS) uniquely predicted shorter gestational length whereas the latent factor did not. CONCLUSION These results support existing evidence indicating that pregnancy anxiety is a reliable risk factor for earlier birth. Findings point to possible screening for clinically significant anxiety symptoms in the first trimester, and pregnancy-specific anxiety thereafter to advance efforts to prevent earlier delivery. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
| | - Danny Rahal
- Departments of Psychology University of California, Los Angeles
| | - Carolyn Ponting
- Departments of Psychology University of California, Los Angeles
| | - Melissa Julian
- Department of Psychological and Brain Sciences, George Washington University
| | - Isabel Ramos
- Department of Chicano/Latino Studies, University of California, Irvine
| | - Calvin Hobel
- Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center
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Kornfield SL, Johnson RL, Hantsoo LV, Kaminsky RB, Waller R, Sammel M, Epperson CN. Engagement in and Benefits of a Short-Term, Brief Psychotherapy Intervention for PTSD During Pregnancy. Front Psychiatry 2022; 13:882429. [PMID: 35782453 PMCID: PMC9240269 DOI: 10.3389/fpsyt.2022.882429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 05/09/2022] [Indexed: 11/26/2022] Open
Abstract
Trauma-related symptoms and post-traumatic stress disorder (PTSD) are common during pregnancy and have adverse effects on pregnancy and birth outcomes, post-partum maternal mental health, and child development. The arousal symptoms associated with PTSD, including heightened or dysregulated physiology, may contribute to these adverse outcomes. Low-income minoritized women may be at highest risk given more lifetime exposure to trauma and limited access to mental health care. While evidence-based psychotherapies for PTSD exist, none are targeted to non-treatment seeking individuals nor specifically integrated with prenatal care. Thus, we developed and tested the efficacy of a short-term (four sessions) brief (30-45 min) psychotherapeutic intervention designed to address PTSD symptoms in pregnant women receiving prenatal care at two urban medical centers. Participants were 32 pregnant women with an average gestational age of 18.5 weeks at the time of enrollment. The sample was overwhelmingly non-Caucasian, single, and reported very low income. Participants completed measures of trauma-related symptoms (Post-traumatic Stress Disorder Checklist, PCL), and depression (Edinburgh post-natal Depression Scale, EPDS) at baseline, twice during treatment, post-treatment, and at 10-14 weeks post-partum. The intervention was successful at significantly decreasing symptoms of PTSD (PCL score = -20.27, 95% CI: -25.62, -14.92, P < 0.001, W = -7.43) and depression (EPDS score = -4.81, 95% CI: -7.55, -2.06, P = 0.001, W = -3.23) by the final session. These benefits were sustained at post-treatment and post-partum follow ups. Future research should further explore the effectiveness of this treatment in a randomized controlled trial.
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Affiliation(s)
- Sara L Kornfield
- Penn Center for Women's Behavioral Wellness, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Rachel L Johnson
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado, Denver, CO, United States
| | - Liisa V Hantsoo
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Rachel B Kaminsky
- Penn Center for Women's Behavioral Wellness, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Rebecca Waller
- Psychology Department, University of Pennsylvania, Philadelphia, PA, United States
| | - Mary Sammel
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado, Denver, CO, United States.,Department of Psychiatry, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - C Neill Epperson
- Department of Psychiatry, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.,Department of Family Medicine, School of Medicine, University of Colorado, Aurora, CO, United States
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