Validity and Reliability of the Spanish Version of the Pregnancy-Related Thoughts Scale

Evaluating the factor structure of the pregnancy-related anxiety scale: implications for maternal and infant wellbeing

AIMS/BACKGROUND

Although the Pregnancy-Related Anxiety Scale - also referred to as the Pregnancy-Related Thoughts Scale (PRT) - is one of the most widely utilised measures of pregnancy-related anxiety (PrA), there is limited research exploring its factor structure and psychometric properties. The present study sought to (a) explore the factor structure of the PRT and (b) examine whether specific dimensions of PrA differentially predict postpartum outcomes.

DESIGN/METHODS

A community sample of pregnant women (N = 159) was recruited from a Midwestern city in the United States and completed the PRT alongside other self-report measures of stress and maternal health and mood during pregnancy. Participants also completed measures of maternal health and mood, as well as parenting/infant outcomes, at 1- and 6-months postpartum.

RESULTS

Results provided support for a bifactor model with two unique dimensions of the PRT capturing baby- and self-focused concerns, respectively. Maternal self-focused PrA uniquely predicted postpartum internalising problems (β = .22), worse physical health (β = -.27), and impaired mother-infant bonding (β = .19) when controlling for baby-focused and general PrA.

CONCLUSION

Findings highlight the utility of screening for specific dimensions of PrA to promote both maternal and infant wellbeing following childbirth. Specifically, evidence suggests that screening for self-focused PrA, above and beyond baby-focused PrA, might facilitate prevention and intervention efforts and allow researchers to better understand antecedents and consequences of unique facets of PrA.

Helping Us Grow Stronger (HUGS)/Abrazos: a community-based initiative improved perinatal mental health in an urban cohort

BACKGROUND

Targeted programs aimed at improving maternal mental health, particularly among those exposed to social determinants of health, are increasingly critical since the onset of the COVID-19 pandemic, yet the impact of such programs is poorly understood.

OBJECTIVE

This study aimed to evaluate the impact of a novel, language-concordant community-based program on perinatal mental health.

STUDY DESIGN

We conducted a prospective cohort study of peripartum individuals referred to a new community-based intervention known as Helping Us Grow Stronger (HUGS/Abrazos). Participants received up to 4 remote sessions with a cognitive behavioral therapy trained social worker, up to 3 resource navigation sessions with a community health worker, and direct relief with a grocery gift card and care package. Before and after the program, participants completed validated survey instruments to assess mental health and social determinants of health.

RESULTS

A total of 178 participants were assessed after program completion, including 133 who were assessed before and after the program. The cohort was composed of 62.9% Hispanic or Latinx participants with a mean age of 29.8 year (standard error of mean, 0.46). There were high rates of food insecurity (111/178; 62.4%), experiences of discrimination (119/178; 66.9%), and SARS-CoV-2 infection (105/178; 59.0%). The program was associated with statistically significant improvements in the Edinburgh Postnatal Depression scores (baseline [mean±standard error of mean], 8.44±0.55 vs 6.77±0.51 after program completion; P=.0001) and Perceived Stress Scale scores (baseline, 15.2±0.74 vs 14.0±0.71; P=.035). Participants exposed to stressors including food insecurity and experiences of discrimination had higher baseline depression, stress, and anxiety scores. Those with experiences of discrimination, food insecurity, and SARS-CoV-2 infection during pregnancy were more likely to have improvements in mental health scores postintervention.

CONCLUSION

In this diverse urban cohort, a novel community-based intervention was associated with improvements in depressive symptoms, perceived stress, and anxiety, particularly among those with social determinants of health.

Psychometric analysis of the Edinburgh Postnatal Depression Scale and Pregnancy Related Anxiety Questionnaire in Pakistani pregnant women

BACKGROUND

The Edinburgh Postnatal Depression Scale (EPDS) and the Pregnancy-Related Anxiety Scale (PRAQ) are frequently used perinatal mental health scales.

OBJECTIVE

To identify the factor structure of the Urdu language versions of EPDS and PRAQ in 280 Pakistani pregnant women.

METHOD

The tools were administered at 12-19 weeks' and 22-29 weeks' gestational age (GA). Exploratory factor analyses were undertaken on data collected at 12-19 weeks' GA, to assess both scales. Results obtained at the second time point were used to examine test-retest reliability. The correlation between the scales was computed.

RESULTS

A two-factor model yielded the best fit for both scales, which is consistent with findings from previous studies. For the EPDS, acceptable reliability was attained for the overall score (α = 0.77) and for the factor related to depressive symptoms (α = 0.73), but not for the factor related to anhedonia/suicide (α = 0.64). For the PRAQ, acceptable reliability was attained for the overall score (α = 0.83) and for the factor related to pregnancy concerns (α = 0.84), but not for the factor related to childbirth (α = 0.64). Test-retest reliability was acceptable for both overall scales EPDS: r = 0.50; PRAQ: r = 0.45; both p < .001). The Pearson correlation between the EPDS and PRAQ were r = 0.145, p < .05.

CONCLUSION

Analysis of the tools confirmed a two-factor structure for both depression and anxiety among Pakistani pregnant women. A weak correlation was found between the EPDS and PRAQ. Further research is required to develop screening instruments for perinatal mental disorders that are applicable to cultural contexts.

Turkish version of the Pregnancy-related Anxiety Scale: A psychometric study

PURPOSE

To adapt the Pregnancy-related Anxiety Scale (PrAS) into Turkish and evaluate its psychometric properties.

DESIGN AND METHODS

This cross-sectional study comprised of 400 pregnant women. The PrAS was translated using the methods of translation, back-translation, consensus meetings, and a trial of potential users. Then, its psychometric properties were evaluated by exploratory factor analysis and confirmatory factor analysis.

FINDINGS

The PrAS consists of 33 items. Following the exploratory factor analysis, the two items in the scale were discarded because factor loads were less than 0.50, therefore, the number of items decreased from 33 to 31. In the confirmatory factor analysis, the goodness-of-fit indices of the scale were found to be suitable. The internal consistency coefficient calculated for the reliability of the scale was .89. After correlating it with another scale for measuring pregnancy distress, the Turkish version of the PrAS shows discriminant validity.

PRACTICE IMPLICATIONS

The Turkish version of the PrAS is a valid and reliable instrument that can be used to evaluate pregnancy-related-anxiety. The use of the PrAS in prenatal healthcare services will contribute to the early diagnosis, treatment, and management of pregnancy-related anxiety.