Risk factors for antenatal anxiety: A systematic review of the literature

ABSTRACT

Background: Given the prevalence of antenatal anxiety and its consistent associations with adverse pregnancy and child outcomes, early detection and management of anxiety are essential.

Objective: The aim was to identify risk factors for anxiety among pregnant women by systematically reviewing original research.

Methods: Cross-sectional, case-control and cohort studies that examined associations between antenatal anxiety and at least one potential risk factor prospectively or retrospectively and measured anxiety independent from other mental health conditions were included. Studies rated strong/moderate in methodological quality appraisal were used to synthesise the evidence.

Results: Factors associated with greater risk of anxiety included previous pregnancy loss, medical complications, childhood abuse, intimate partner violence, denial/acceptance coping styles, personality traits, inadequate social support, history of mental health problems, high perceived stress and adverse life events.

Conclusions: Several risk factors identified in this review are detectable in routine prenatal care visits (e.g. previous pregnancy loss, pregnancy complications), potentially modifiable (e.g. coping styles, social support, partner factors) and can be identified prior to pregnancy (e.g. psychosocial factors), underlining the significance of pre-conception mental health screening.

KEYWORDS:

• Pregnancy
• antenatal anxiety
• review

Acknowledgements

This review was funded by a small grant from Alberta Centre For Child Family & Community Research.

Declarations of interest

The authors have no conflicts of interest to disclose.

Additional information

Funding

This work was supported by the Alberta Centre for Child, Family and Community Research.