Maternal Anxiety and the Second-Trimester Prenatal Screening: A Prospective Cohort Study.
OBJECTIVE
Assessing the effects of maternal anxiety on the markers and results of quadruple screening and on maternal anxiety after receiving positive results.


METHODS
This prospective cohort study evaluated 1,595 pregnant women referred for prenatal visits. Maternal state/trait anxiety levels were measured, then quadruple screening was performed by measuring serum α-fetoprotein (AFP), β-human chorionic gonadotropin, inhibin A, and unconjugated estriol (UE3). After receiving the results, the state/trait anxiety was remeasured. Amniocentesis was performed for screening-positive mothers.


RESULTS
High prescreening maternal anxiety was associated with lower rates of elevated AFP (OR, 0.27; 95% CI, 0.1-0.74) and elevated inhibin A (OR, 0.38; 95% CI, 0.15-0.98). High maternal anxiety was associated with higher rates of decreased UE3 (OR, 1.8; 95% CI, 1.06-3.08). There were no significant associations between prescreening maternal anxiety and the final screening or amniocentesis results. Among the screening-positive mothers, those who had high state/trait anxiety before screening had higher anxiety scores after receiving positive results compared to those with low prescreening anxiety levels (52.9 ± 10.8 vs. 43.7 ± 10.3).


CONCLUSIONS
High prescreening maternal anxiety is associated with lower rates of elevated AFP and inhibin A and higher rates of decreased UE3. However, maternal anxiety does not affect the final screening or amniocentesis result. High maternal state/trait anxiety before screening is associated with significantly higher maternal anxiety after the receipt of positive results.
Maternal, Fetal and Neonatal Research Center, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Sanaz
S
Mousavi
Sedigheh
S
Hantoushzadeh
Mahdi
M
Sheikh
Mamak
M
Shariat
D000328:Adult; D000649:Amniocentesis / Q000523:psychology; D001007:Anxiety / Q000097:blood / Q000453:epidemiology*; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D004964:Estriol / Q000097:blood; D005260:Female; D006801:Humans; D007265:Inhibins / Q000097:blood; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011296:Prenatal Diagnosis / Q000523:psychology*; D011446:Prospective Studies; D000509:alpha-Fetoproteins / Q000378:metabolism
D018997:Chorionic Gonadotropin, beta Subunit, Human; D000509:alpha-Fetoproteins; C422362:inhibin A; D007265:Inhibins; D004964:Estriol