Cited by 406Maternal Mental Health During Pregnancy and PostpartumMaternal and Neonatal HealthcareMaternal and Perinatal Health Interventions

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Maternal Anxiety During Pregnancy and the Association With Adverse Perinatal Outcomes: Systematic Review and Meta-Analysis

Grigoriadis, Sophie, Graves, Lisa, Peer, Miki, Mamisashvili, Lana, Tomlinson, George, Vigod, Simone N., Dennis, Cindy-Lee, Steiner, Meir, Brown, Cara, Cheung, Amy, Dawson, Hiltrud, Rector, Neil A., Guenette, Melanie, Richter, Margaret·2018·The Journal of Clinical Psychiatry

DOI 10.4088/jcp.17r12011

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Abstract

OBJECTIVE: This systematic review and meta-analysis examined the association between maternal antenatal anxiety (AA) and a range of perinatal outcomes. DATA SOURCES: Ovid MEDLINE, MEDLINE In-Process and Other Non-Indexed Citations, PsycINFO, CINAHL, Embase, and the Cochrane Library were searched to May 31, 2016, using controlled vocabulary and keywords (eg, prenatal, anxiety, preterm). STUDY SELECTION: Perinatal outcomes of women with and without AA (diagnosed or self-reported using validated scale) derived from English language, prospectively collected data were included. 1,458 abstracts were reviewed, 306 articles were retrieved, and 29 articles were included. DATA EXTRACTION: Two independent reviewers extracted data and assessed quality. Random-effects models were utilized for outcomes (≥ 3 studies). Subanalyses examined potential effect moderators including study quality and diagnostic versus self-reported anxiety among others. RESULTS: Antenatal anxiety was associated with increased odds for preterm birth (pooled odds ratio [OR] = 1.54; 95% confidence interval [CI], 1.39 to 1.70, 16 studies) and spontaneous preterm birth (OR = 1.41; 95% CI, 1.13 to 1.75), lower mean birth weight (mean difference = -55.96 g; 95% CI, -93.62 to -18.31 g), increased odds for low birth weight (OR = 1.80; 95% CI, 1.48 to 2.18), earlier gestational age (mean difference = -0.13 wk; 95% CI, -0.22 to -0.04 wk), increased odds for being small for gestational age (OR = 1.48; 95% CI, 1.26 to 1.74), and smaller head circumference (mean difference = -0.25 cm; 95% CI, -0.45 to -0.06 cm). Heterogeneity between studies was not significant for most outcomes. Subanalyses for birth weight found women with diagnosed anxiety had infants with significantly lower birth weight (P < .03) compared to those identified with rating scales (although both subanalyses were significant [P < .01]). Associations between anxiety and preeclampsia, cesarean delivery, and Apgar scores were nonsignificant. CONCLUSIONS: Antenatal anxiety is associated with multiple adverse perinatal outcomes and is not benign. The impact of treating anxiety on these associations is unknown.

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Authors: Grigoriadis, S., Graves, L., Peer, M., Mamisashvili, L., Tomlinson, G., Vigod, S. N., Dennis, C.-L., Steiner, M., Brown, C., Cheung, A., Dawson, H., Rector, N. A., Guenette, M., & Richter, M.
Affiliations: Sunnybrook Health Science Centre (CA)
Western Michigan University (US)
University of Toronto (CA)
St. Joseph’s Healthcare Hamilton (CA)
St. Michael's Hospital (CA)
Corresponding author: Grigoriadis, Sophie
ORCID: Grigoriadis, Sophie
Graves, Lisa
Peer, Miki
Tomlinson, George
Vigod, Simone N.
Dennis, Cindy-Lee
Steiner, Meir
Cheung, Amy
Rector, Neil A.
Guenette, Melanie
Richter, Margaret
Venue: The Journal of Clinical Psychiatry
Publisher: Physicians Postgraduate Press, Inc
Published: 2018-09-04
Volume: 79
Issue: 5
ISSN: 0160-6689 (ISSN-L)
1555-2101
DOI: 10.4088/jcp.17r12011
OpenAlex: W2889131270
Cited by: 404
References: 0
Citations by year: 2026: 50 · 2025: 54 · 2024: 70 · 2023: 64 · 2022: 69 · 2021: 61 · 2020: 24 · 2019: 11
FWCI: 22.85
Type: journal article
Language: en
Open access: closed
Locations: The Journal of Clinical Psychiatry (publishedVersion)
PubMed (publishedVersion)
Funders: Canadian Institutes of Health Research (141002_1)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Keywords: prenatal anxiety, perinatal outcomes, preterm birth, low birth weight, small for gestational age, head circumference, preeclampsia, gestational diabetes mellitus, fetal growth restriction, macrosomia, neonatal intensive care admission, neonatal mortality, neonatal morbidity, birth weight prediction, gestational age at delivery
MeSH terms: Anxiety, Female, Humans, Pregnancy, Pregnancy Complications, Pregnancy Outcome

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Maternal Anxiety During Pregnancy and the Association With Adverse Perinatal Outcomes: Systematic Review and Meta-Analysis

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