The Association between Prenatal Anxiety and Spontaneous Preterm Birth and Low Birth Weight

Background: The effect of psychological factors on preterm delivery is still inconsistent. It was shown that psychological factors to increase maternal corticotrophin-releasing factor to play an important role in preterm delivery. This study was conducted to determine the effect of prenatal anxiety on spontaneous preterm delivery and low birth weight (LBW) in Babol, Northern Iran. Methods: 682 women with singleton pregnancies who were consecutively recruited between 20 and 28 weeks of gestation in Babol Health Care centers for prenatal care were enrolled. Women who had history of psychological and chronic diseases, pregnancy complications and taking medicine were excluded from the study. The gestational age was based on last menstrual period or ultrasound examination in first half of pregnancy. Anxiety was assessed using self-administered questionnaires: the Spielberger State-Trait Anxiety Inventory. The women were considered as case group with anxiety score ≥45. Results: The mean Spielberger state and trait anxiety in women with preterm delivery were respectively 42.7±10.8 and 52.9±3.9, but the mean Spielberger state and trait anxiety in women with term delivery were respectively 37.81±5.71 and 50.68±5.20. A significant association was found between scores for both Spielberger state anxiety and trait anxiety ≥45 and preterm and LBW. A high score state anxiety (≥45) was significantly associated with an increase in preterm delivery. Conclusion: Screening for mental and psychological disorders among women in regular prenatal care is recommended.