Pregnancy-specific anxiety and its association with background characteristics and health-related behaviors in a low-risk population

Myrte Westerneng, Anke B Witteveen, J Catja Warmelink, Evelien Spelten, Adriaan Honig, Paul de Cock

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    BACKGROUND: Pregnancy-specific anxiety is an important risk factor for adverse pregnancy outcomes. It is therefore needed to gain insight in which women are at risk for elevated levels (> 85th percentile) of pregnancy-specific anxiety. Additionally, given that unhealthy behaviour has been suggested as a possible pathway linking pregnancy-specific anxiety to adverse pregnancy outcomes, it is important to examine whether higher levels of pregnancy-specific anxiety are associated with negative health-related behaviours (smoking, alcohol use and too much weight gain).

    METHODS: Using a study sample of 4541 low-risk pregnant women who filled in the Pregnancy Related Anxiety Questionnaire-Revised (PRAQ-R), we first examined which socio-demographic, pregnancy-related and psychological background characteristics were significantly associated with a PRAQ-R score above the 85th percentile. Secondly, we examined the association between pregnancy-specific anxiety and self-reported health-related behaviours (smoking, alcohol use and too much weight gain) while controlling for significant background characteristics. For both research questions, backward regression analysis was applied.

    RESULTS: Results showed that nulliparity (OR=2.33, 95% confidence interval (CI)=1.97-2.77), anxious or depressed mood (OR=3.29, 95% CI=2.74-3.94) and non-Dutch ethnicity, especially Turkish (OR=3.47, 95% CI=2.16-5.59) or Moroccan (OR=2.97, 95% CI=1.84-4.81), were most strongly associated with elevated pregnancy-specific anxiety levels. Women with higher pregnancy-specific anxiety levels were more likely to gain too much weight during pregnancy (odds ratio (OR) linear term=1.49, 95% CI=1.21-1.83), while both very low and high levels of pregnancy-specific anxiety were associated with smoking (OR linear term=0.13, 95% CI=0.04-0.45, OR quadratic term=1.81, 95% CI=1.32-2.47). No association with alcohol use was found.

    CONCLUSIONS: In conclusion, our results show nulliparity, anxious or depressed mood and non-Dutch ethnicity as three major vulnerability factors for elevated levels of pregnancy-specific anxiety. Furthermore, our results show an association between pregnancy-specific anxiety and negative health-related behaviours, which is worth examining in future studies.

    Original languageEnglish
    Pages (from-to)6-13
    Number of pages8
    JournalComprehensive Psychiatry
    Publication statusPublished - May-2017


    • Adult
    • Alcohol Drinking/psychology
    • Anxiety/ethnology
    • Depression/ethnology
    • Ethnic Groups/psychology
    • Female
    • Health Behavior
    • Humans
    • Morocco/ethnology
    • Netherlands
    • Odds Ratio
    • Parity
    • Pregnancy
    • Pregnancy Complications/ethnology
    • Risk Factors
    • Self Report
    • Smoking/psychology
    • Surveys and Questionnaires
    • Turkey/ethnology
    • Weight Gain

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