Psychosocial predictors of prenatal anxiety

A growing body of research indicates that maternal stress in general, and anxiety in particular, during pregnancy are significant risk factors for adverse birth outcomes. Researchers know very little empirically about the specific psychological and social factors that contribute to perceptions of stress and anxiety for women during pregnancy. To address this critical gap in the literature, this study investigates a variety of factors that may contribute to prenatal anxiety, including mastery, attitudes toward the pregnancy, social support, life events, and demographic factors. Structured interviews were conducted at three intervals in pregnancy (18-20 weeks, 28-30 weeks, and 35-36 weeks) in a sample of 453 European American, African American, and Latina pregnant women. Results from cross-sectional analyses indicated that prenatal anxiety was higher among women who were low in mastery, who had less positive attitudes toward their pregnancy, and who experienced a larger number of life events during pregnancy. In addition, longitudinal analyses revealed that women who had less favorable attitudes toward their pregnancies, and who were lower in mastery, reported increases in prenatal anxiety from early to late pregnancy. Separate analyses for each ethnic group showed that predictors of prenatal anxiety varied by ethnicity. Whereas only income level predicted European American women's anxiety levels, attitudes toward the pregnancy and life events predicted prenatal anxiety for African American women; and mastery, baby's father support, and life events predicted anxiety for Latinas. These findings enable us to further examine the complex emotional processes and their concomitants and evolution in pregnancy, and to consider prenatal interventions for women to reduce risk for adverse emotional and medical outcomes.