The effect of maternal anxiety during delivery on birth outcomes

Öz

ABSTRACT Birth anxiety can be defined as the fear of direct pain, the fear of the birth process. The aim of this study is to investigate the effect of anxiety level at the time of birth on the birth process and maternal and neonatal outcomes. Materials and Methods: Anxiety scores of the patients were recorded. Demographic data of the patients, cervical examination findings, place of residence, education level, type of delivery, APGAR score, presence of episiotomy or dehiscence in normal deliveries, 1st, 2nd and 3rd stages of labor, analgesia needs, prenatal and postnatal hemoglobin variability were recorded. The patients were divided into two groups as those with low (n=76) and moderate/high (n=24) anxiety levels, and the effect of anxiety level on birth outcomes was compared. Results: 53.9% (n=41) of pregnant women with low level of anxiety were nulliparous, and 91.7% (n=22) of patients with moderate/high level of anxiety were nulliparous (p=0.001). Postpartum hemoglobin change in pregnants with low level of anxiety, was higher than the pregnant women with moderate/high level of anxiety (p=0.00). A statistically significant relationship was found between age and anxiety level, the anxiety score of younger pregnant women was significantly higher (p=0.001). Conclusion: Although we did not find a statistically significant relationship between prepartum anxiety level and fetal and neonatal outcomes in our study, the amount of bleeding was less in pregnant women with low anxiety. We also concluded that previous birth experience and maternal age affect the anxiety score. Keywords: Anxiety, birth, fear, fetal, maternal

Anahtar Kelimeler

• Anxiety
• birth
• fear
• fetal
• maternal

Kaynakça

1. 1. American Psychiatric Association, “American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington: American Psychiatric Association; 2013.,” in Diagnostic and statistical manual of mental disorders, 2013.
2. 2. Nyman E, Miettunen J, Freimer N, Joukamaa M, Mäki P, Ekelund J, et al. Impact of temperament on depression and anxiety symptoms and depressive disorder in a population-based birth cohort. J. Affect. Disord., 2011. Jun;131(1-3):393-7.
3. 3. Vänskä M, Punamäki RL, Tolvanen A, Lindblom J, Flykt M, Unkila-Kallio L, et al. Maternal pre- and postnatal mental health trajectories and child mental health and development: Prospective study in a normative and formerly infertile sample. Int. J. Behav. Dev., 2011.;35(6):517-531.
4. 4. Graignic-Philippe R, Dayan J, Chokron S, Jacquet AY, Tordjman S. Effects of prenatal stress on fetal and child development: a critical literature review. Neuroscience & biobehavioral reviews. 2014 Jun 1;43:137-62.
5. 5. Huizink AC, Mulder EJ, de Medina PG, Visser GH, Buitelaar JK. Is pregnancy anxiety a distinctive syndrome?. Early human development. 2004 Sep 1;79(2):81-91.
6. 6. Reading AE. The influence of maternal anxiety on the course and outcome of pregnancy: A review. Health Psychology. 1983;2(2):187.
7. 7. Istvan J. Stress, anxiety, and birth outcomes: a critical review of the evidence. Psychological Bulletin. 1986 Nov;100(3):331.
8. 8. Levin JS, DeFrank RS. Maternal stress and pregnancy outcomes: a review of the psychosocial literature. Journal of Psychosomatic Obstetrics & Gynecology. 1988 Jan 1;9(1):3-16.

9. 9. Lobel M. Conceptualizations, measurement, and effects of prenatal maternal stress on birth outcomes. Journal of behavioral medicine. 1994 Jun;17(3):225-72.
10. 10. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. Journal of consulting and clinical psychology. 1988 Dec;56(6):893.