title: Determinants of maternal antenatal state-anxiety in mid-pregnancy: Role of maternal feelings about the pregnancy.
abstract: BACKGROUND
  The current state of research into antenatal anxiety is lacking in a comprehensive understanding of determinants. This study aims to expand knowledge in this area, with the main objective being to determine potential determinants of maternal antenatal state-anxiety.
  
  
  METHODS
  Data used for this cross-sectional study were obtained from the Prenatal Health Project: a population cohort study of 2357 women in London, Ontario. 1992 women in their second trimester met inclusion criteria for this study. The primary hypothesis was that "feelings about the pregnancy" would be a determinant of antenatal state-anxiety after controlling for other potential covariates. The abbreviated version of the Spielberger State and Trait Anxiety Inventory (STAI) was used to measure state-anxiety. Univariate analyses and multiple linear regression were performed to identify variables predictive of state-anxiety.
  
  
  RESULTS
  Stress, feeling unsure/unhappy about the pregnancy and having low self-esteem, low mastery and low social support from one's partner and family were statistically significant determinants of state-anxiety during the second trimester. In addition, anxiety was found to be inversely related to gestational age.
  
  
  CONCLUSIONS
  The two main limitations of the study were the use of a self-report screening tool (STAI) as the measure of anxious symptoms rather than a clinical diagnosis, and possible recall bias of feelings about the pregnancy.
  
  
  CONCLUSIONS
  We concluded that how a woman feels about her pregnancy was a determinant of state-anxiety. This study contributes knowledge aiming to help women improve their mental health during pregnancy by identifying important determinants of state-anxiety.
authors.affiliation: Department of Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada.
authors.forename: Salwa
authors.initials: S
authors.lastname: Akiki
authors.affiliation: Department of Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada; Department of Paediatrics, University of Western Ontario, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada; Department of Sociology, University of Western Ontario, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada.
authors.forename: William R
authors.initials: WR
authors.lastname: Avison
authors.affiliation: Department of Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada; Department of Paediatrics, University of Western Ontario, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada.
authors.forename: Kathy N
authors.initials: KN
authors.lastname: Speechley
authors.affiliation: Department of Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada; Department of Paediatrics, University of Western Ontario, London, Ontario, Canada; Department of Obstetrics and Gynecology, University of Western Ontario, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada. Electronic address: mcampbel@uwo.ca.
authors.forename: M Karen
authors.initials: MK
authors.lastname: Campbell
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology*; D001294:Attitude to Health; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008131:London; D008603:Mental Health; D009035:Mothers / Q000523:psychology*; D009864:Ontario; D011247:Pregnancy / Q000523:psychology*; D011262:Pregnancy Trimester, Second / Q000523:psychology*; D012307:Risk Factors; D012944:Social Support; D055815:Young Adult
keywords: Antenatal anxiety; Determinants; Feelings about the pregnancy; STAI-State; Second trimester; State-anxiety