Levels and effects of different forms of anxiety during pregnancy after a prior miscarriage

Objectives: The aim of the study was to assess the current level of pregnancy-related fear and state anxiety in pregnant women who experienced prior miscarriages and to explore the impact of higher levels of anxiety during the first trimester on the following course and outcome of the pregnancy. Study design: One hundred forty-three pregnant women who had experienced prior miscarriage (sporadic or recurrent) were measured during each trimester and postpartum. Three independent control groups consisting of pregnant women without a history of miscarriage were recruited. For assessment, a battery of questionnaires including the STAI-state scale and various instruments were administered to record pregnancy-related fear, complications during pregnancy, the course of delivery and the health status of the neonate. Correlations, univariate logistic regression modelling, and ANOVA statistics including post hoc tests were conducted. Results: Compared to women without miscarriages, women with prior miscarriage had higher levels of pregnancy-related fear and state anxiety during the first trimester. The level of anxiety differed between pregnant women with a single as compared to those with recurrent miscarriage. Early pregnancy-related fear significantly correlated with complications during pregnancy and delivery. This effect was not found for state anxiety. Conclusions: This study suggests that miscarriages may lead to higher levels of pregnancy-related fear and state anxiety. In particular, pregnancy-related fear may have a negative impact on the course of pregnancy and delivery. Thus, interventions to reduce pregnancy-related fear are highly recommended. (C) 2008 Elsevier Ireland Ltd. All rights reserved.