title: A psychometric systematic review of self-report instruments to identify anxiety in pregnancy.
abstract: OBJECTIVE
  To report a systematic review of the psychometric properties of self-report instruments to identify the symptoms of anxiety in pregnancy to help clinicians and researchers select the most suitable instrument.
  
  
  BACKGROUND
  Excessive anxiety in pregnancy is associated with adverse birth outcomes, developmental and behavioural problems in infants and postnatal depression. Despite recommendations for routine psychological assessment in pregnancy, the optimal methods to identify anxiety in pregnancy have not been confirmed.
  
  
  METHODS
  Psychometric systematic review.
  
  
  METHODS
  A systematic literature search of the multiple databases (1990-September 2014).
  
  
  METHODS
  Identification of self-report instruments to measure anxiety in pregnancy using COSMIN guidelines to assess studies reporting a psychometric evaluation of validity and reliability.
  
  
  RESULTS
  Thirty-two studies were included. Studies took place in the UK, Australia, Belgium, Canada, Germany, Italy, Scandinavia, Spain and the Netherlands. Seventeen different instruments were identified. Measures of validity were reported in 19 papers and reliability in 16. The overall quality of the papers was rated as fair to excellent using the COSMIN checklist. Only one paper scored excellent in more than one category.
  
  
  CONCLUSIONS
  Many instruments have been adapted for use in different populations to those for which they were designed. The State Trait Anxiety Inventory, Edinburgh Postnatal Depression Scale and the Hospital Anxiety and Depression Scale have been tested more frequently than other instruments, yet require further assessment to confirm their value for use in pregnancy.
authors.affiliation: Nottingham University Hospitals NHS Trust, UK.
authors.forename: Kerry
authors.initials: K
authors.lastname: Evans
authors.affiliation: School of Health Sciences, University of Nottingham, UK.|School of Nursing and Midwifery, University of Queensland, Brisbane, Australia.
authors.forename: Helen
authors.initials: H
authors.lastname: Spiby
authors.affiliation: School of Health Sciences, University of Nottingham, UK.
authors.forename: C Jane
authors.initials: CJ
authors.lastname: Morrell
mesh_terms: D001007:Anxiety / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D011594:Psychometrics; D012647:Self-Assessment
keywords: antenatal care; anxiety; midwifery; nursing; pregnancy; psychometric systematic review; psychometric testing