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. 2022 Apr 15;22(1):331.
doi: 10.1186/s12884-022-04661-8.

Measurement of pregnancy-related anxiety worldwide: a systematic review

Kristin Hadfield  1 , Samuel Akyirem  2 , Luke Sartori  3 , Abdul-Malik Abdul-Latif  4 , Dominic Akaateba  5 , Hamideh Bayrampour  6 , Anna Daly  7 , Kelly Hadfield  5 , Gilbert Abotisem Abiiro  8   9
Affiliations

Measurement of pregnancy-related anxiety worldwide: a systematic review

Kristin Hadfield et al. BMC Pregnancy Childbirth. .

Abstract

Background: The perinatal period is often characterized by specific fear, worry, and anxiety concerning the pregnancy and its outcomes, referred to as pregnancy-related anxiety. Pregnancy-related anxiety is uniquely associated with negative maternal and child health outcomes during pregnancy, at birth, and early childhood; as such, it is increasingly studied. We examined how pregnancy-related anxiety is measured, where measures were developed and validated, and where pregnancy-related anxiety has been assessed. We will use these factors to identify potential issues in measurement of pregnancy-related anxiety and the geographic gaps in this area of research.

Methods: We searched the Africa-Wide, CINAHL, MEDLINE, PsycARTICLES, PsycINFO; PubMed, Scopus, Web of Science Core Collection, SciELO Citation Index, and ERIC databases for studies published at any point up to 01 August 2020 that assessed pregnancy-related anxiety. Search terms included pregnancy-related anxiety, pregnancy-related worry, prenatal anxiety, anxiety during pregnancy, and pregnancy-specific anxiety, among others. Inclusion criteria included: empirical research, published in English, and the inclusion of any assessment of pregnancy-related anxiety in a sample of pregnant women. This review is registered on PROSPERO (CRD42020189938).

Results: The search identified 2904 records; after screening, we retained 352 full-text articles for consideration, ultimately including 269 studies in the review based on the inclusion and exclusion criteria. In total, 39 measures of pregnancy-related anxiety were used in these 269 papers, with 18 used in two or more studies. Less than 20% of the included studies (n = 44) reported research conducted in low- and middle-income country contexts. With one exception, all measures of pregnancy-related anxiety used in more than one study were developed in high-income country contexts. Only 13.8% validated the measures for use with a low- or middle-income country population.

Conclusions: Together, these results suggest that pregnancy-related anxiety is being assessed frequently among pregnant people and in many countries, but often using tools that were developed in a context dissimilar to the participants' context and which have not been validated for the target population. Culturally relevant measures of pregnancy-related anxiety which are developed and validated in low-income countries are urgently needed.

Keywords: Background; Cross-cultural; Maternal mental health; Measurement; Pregnancy; Pregnancy-related anxiety; Reliability and validity; Systematic review.

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Conflict of interest statement

The authors have no conflict of interest.

Figures

Fig. 1
Fig. 1
Study selection
Fig. 2
Fig. 2
Number of studies on pregnancy-related anxiety by country in which the study was conducted
See this image and copyright information in PMC

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