Fetal health anxiety: development and psychometric properties of the fetal health anxiety inventory

Abstract

Objective: To develop a measure to assess fetal health anxiety and examine its factor structure, convergent and divergent validity.

Methods: In Study 1, the Short Health Anxiety Inventory-14 item version (SHAI) (Salkovskis et al., Psychol Med. 2002;32:843–853) was adapted for use with pregnant women to examine fetal health anxiety named the Fetal Health Anxiety Inventory (FHAI). Four pregnant women and three subject matter experts (SMEs) reviewed the FHAI. In Study 2, 100 pregnant women completed the FHAI and related self-report measures.

Results: In Study 1, both reviewer groups provided feedback directing minor changes to the FHAI. In Study 2, a revised version was used. The revised FHAI demonstrated excellent internal consistency (α = 0.91). Results from an EFA suggested that the FHAI may be conceptualized as a one- or two-factor scale. Convergent (pregnancy-related anxiety [r = 0.56, p = .0001], parental health anxiety [r = 0.53, p = .0001], anxiety [r = 0.57, p = .0001], anxiety sensitivity [r = 0.28, p = .004] and intolerance of uncertainty [r = 0.29, p = .003]) and divergent (parental depression [r = 0.16, p = .12]) validity was evidenced with additional measures of interest.

Conclusion: Preliminary findings suggest that the FHAI represents a psychometrically sound instrument to measure the construct of fetal health anxiety. Practical and theoretical implications of the present results are discussed.

Keywords:

• Fetal health anxiety
• health anxiety
• anxiety
• maternal health

Acknowledgements

The authors would like to thank the participants.

Disclosure statement

No potential conflict of interest was reported by the authors.

Current knowledge on this subject

• Fetal health anxiety refers to an expectant mother's anxiety regarding the health of her developing fetus.

• Research has demonstrated relationships between elevated pregnancy-related anxiety (which includes concerns about health of developing fetus) and pre-term labor, prolonged labor, labor pain, low birth weight, preference for cesarean section, and unplanned cesarean section as well as with postpartum parenting stress.

• To-date no comprehensive measure of fetal health anxiety exists.

What this study adds

• Provides initial evidence of the psychometric properties of the FHAI.

• Our results suggest that pregnant women do experience fetal health anxiety and these concerns are associated with maternal health anxiety, general anxiety, anxiety sensitivity, and intolerance of uncertainty.

• The development of the FHAI will aid in more clearly assessing and understanding maternal anxiety pertaining to the fetus specifically, and the possible association with postpartum functioning.

Additional information

Funding

This work was supported by the Social Science and Research Humanities Council (SSHRC) [752-2014-1065] in the form of a Doctoral Award for the first author.