Review Article: Anxiety, depression and stress in pregnancy: A multivariate model of intra-partum risks and pregnancy outcomes

Abstract

This study evaluated a multivariate model in which the influence of maternal anxiety, depression and stress on infant postnatal status are seen as mediated by attitudes toward pregnancy, internal vs. external locus of control and perception of available social supports. Ante-partum and intra-partum complications are also included since they are associated with anxiety, depression and stress and have been shown to influence infant postnatal status. A total of 133 pregnant women completed: Beck Depression Inventory; State-Trait Anxiety Inventory; PERI Life Events Scale; Rotter I-E Scale, Maternal Attitude Toward Pregnancy; Perceived Social Support Inventory. Composite Perinatal Risk Scales, Outcome-Specific Scales, the Nesbitt-Aubry Maternal-Child Health Care Index and Aubry-Pennington Labor Index were scored from medical records. Anxiety, depression and stress in pregnancy, while weakly correlated with outcome, showed expected relationships with mediating factors predicting gestational age, 5-min Apgar and Neonatal Factors scores. Mediating factors with perinatal scores best predicted 1-min Apgar and Postnatal Complications scores. Results support the notion that these variables work in synergy. the new risk scales produced stronger beta weights than personality, stress and mediator variables and stronger equations than Nesbitt-Aubry or Aubry-Pennington scales.