Caroline Orr, Suezanne Tangerose Orr, Ph.D., Dan Blazer, Ph.D., Sherman James, Ph.D.

Prenatal Pregnancy-Related Anxiety and Outcomes of Pregnancy among Black Women in the Baltimore Preterm Birth Study

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The objective of this research was to test hypotheses about the associations between maternal prenatal pregnancy-related anxiety (i.e., worries and concerns about the pregnancy) with preterm birth and low birthweight among a sample of Black women. Several studies have identified pregnancy-related anxiety as significantly associated with preterm birth.  However, no prior studies of which we are aware have focused on a sample of Black women, nor has a prior study assessed the associations between pregnancy-related anxiety with both preterm birth and low birthweight as pregnancy outcomes of interest.

The study hypotheses were that Black women with higher levels of pregnancy-related anxiety would have a greater risk of preterm birth and low birthweight than those women with lower levels of pregnancy-related anxiety.  Women were enrolled in the study and completed a questionnaire at the first visit at five prenatal clinics. The clinics were all in the city of Baltimore and served primarily economically disadvantaged women. Data were obtained from medical charts on behavioral variables, gestational age and birthweight. Pregnancy-related anxiety was measured using six items from the Prenatal Social Environment Inventory, and scores ranged from 0-6, with a median of 3. Scores were split at the median for analysis into “high” and “low” groups. . The sample consisted of 922 women.  Overall, 13.7 percent had preterm outcomes and 12.2 percent had low birthweight outcomes. Preterm birth occurred to 11.1% of women with low pregnancy-related anxiety, and for those with high pregnancy related anxiety, preterm birth occurred to 16.0 % of women (p=.02). For women with low pregnancy related anxiety, low birthweight occurred to 9.5% of women and for those with high pregnancy related anxiety, low birthweight occurred to 14.6% of women (p=.01). Pregnancy-related anxiety was associated with preterm birth and low birthweight.  This may suggest a means to improve harmful pregnancy outcomes among Black women by alleviating pregnancy-related concerns and worries.

Keywords: Pregnancy-related anxiety, preterm birth, low birthweight