Anxiety among women experiencing medically complicated pregnancies: A narrative review of literature




Abrar, Ambar

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Background: Medical complications in pregnancy can be a significant source of stress for pregnant women and their partners. Despite this, and evidence that anxiety is very common among perinatal women, little is known about the relationship between perinatal anxiety and medical complications in pregnancy. Purpose: The purpose of this research was to conduct a systematic review of the extant literature pertaining to medical complications of pregnancy and anxiety. Specific objectives were to (a) investigate differences in anxiety experience (symptoms and/or disorder) between women experiencing a medically complicated pregnancy and women experiencing a medically uncomplicated pregnancy, and (b) investigate the nature and scope of perinatal anxiety among women whose pregnancy is fraught with medical problems. Methods: The review was guided by the PRISMA reporting process. The electronic databases MEDLINE and PsycINFO were searched to identify studies that met the study inclusion criteria. Data were extracted and presented in a narrative form including tables and figures. An adapted form of the Newcastle-Ottawa Quality Assessment Scale for case-control and prevalence studies was used to perform a quality assessment review. Results: Twelve studies met the inclusion criteria. Findings indicated that anxiety symptom severity was greater among women experiencing a medically complicated pregnancy compared to those experiencing an uncomplicated pregnancy. The prevalence studies in which symptoms of anxiety were assessed at various times during pregnancy indicate that, among women experiencing a medically high-risk pregnancy, reported symptoms were most severe at initial assessment. Though an exact estimate cannot be provided due to methodological differences, these studies reported the prevalence rates of anxiety symptoms to range from 7.8% to 46.9%. The included studies that used DSM-IV criteria concluded that the risk may be most significant for two disorders: obsessive-compulsive disorder (OCD) and generalized anxiety disorder (GAD). Based on the overall quality of the available studies, the findings cannot be called as bias-free Conclusions: Women experiencing a medically complicated pregnancy appear to experience significantly more symptoms of anxiety compared to women experiencing a healthy pregnancy.



Anxiety, Pregnancy, Medical complications, Literature review