Anxiety associated with diagnostic uncertainty in early pregnancy

Richardson, Alison; Raine‐Fenning, Nick; Deb, Shilpa; Campbell, Bruce; Vedhara, Kavita

doi:10.1002/uog.17214

Cited by 37 publications

(28 citation statements)

References 19 publications

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“…Vaginal bleeding or pelvic pain might be related to prenatal anxiety according to previous studies before the COVID-19 epidemic. For example, Richardson et al (2017) claimed that the experience of vaginal bleeding and/or abdominal pain in early pregnancy was highly anxiogenic. Pelvic pain and vaginal bleeding may rise anxiety in pregnant women because their association with miscarriage (Kilfoyle et al, 2016) or diagnostic uncertainty (Richardson et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

“…For example, Richardson et al (2017) claimed that the experience of vaginal bleeding and/or abdominal pain in early pregnancy was highly anxiogenic. Pelvic pain and vaginal bleeding may rise anxiety in pregnant women because their association with miscarriage (Kilfoyle et al, 2016) or diagnostic uncertainty (Richardson et al, 2017). Pelvic pain or vaginal bleeding was both pregnancy-related and COVID-19 related stressful events, as we mentioned above.…”

Section: Discussionmentioning

confidence: 99%

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Association of Stress-Related Factors With Anxiety Among Chinese Pregnant Participants in an Online Crisis Intervention During COVID-19 Epidemic

et al. 2021

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Background: Previous systematic review indicated the prevalence of prenatal anxiety as 14–54%. Pregnant women are a high-risk population for COVID-19. However, the prevalence of anxiety symptoms and related factors is unknown in Chinese pregnant women during COVID-19 outbreak.Objective: To investigate the prevalence of anxiety symptoms and the related factors in Chinese pregnant women who were attending crisis intervention during the COVID-19 pandemic.Methods: The data of this cross-sectional study were collected in about 2 months (February 28 to April 26, 2020). Data analysis was performed from April to May 2020. Participants completed a set of questionnaires via the Wechat Mini-program before starting the online self-help crisis intervention for COVID-19 epidemic. A total of 2,120 Chinese pregnant women who were attending a self-help crisis intervention participated in this study. A survey was developed to address possible stress-related factors in pregnant women during the COVID-19 outbreak, including demographic, socioeconomic, and pregnancy-related factors, as well as COVID-19 related factors. Generalized Anxiety Disorder-7 (GAD-7) scale and the 10-item perceived stress scale were, respectively, employed to measure anxiety and stress-related factors.Results: A total of 21.7% (459) of pregnant women reported at least mild anxiety (≥5 on the GAD-7 scale), and only 82 women reported moderate to severe anxiety (≥10 on the GAD-7 scale). Factors associated with at least mild anxiety included living in Hubei province (OR = 1.68, 95% CI = 1.32–2.13), nobody providing everyday life support (OR = 1.81, 95% CI = 1.18–2.77), pelvic pain or vaginal bleeding (OR = 1.67, 95% CI = 1.32–2.09), and higher perceived stress (OR = 6.87, 95% CI = 5.42–9.02). Having relatives or neighbors with a diagnosis of COVID-19 was not associated with anxiety (p > 0.05).Conclusions and Relevance: Our findings indicate that evaluation and intervention for maternal and infant health are necessary in pregnant women with anxiety during COVID-19 epidemic, especially those with higher perceived stress, less everyday life support, or vaginal bleeding. Interactions among these related medical, social and psychological factors need to be investigated in future studies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Association of Stress-Related Factors With Anxiety Among Chinese Pregnant Participants in an Online Crisis Intervention During COVID-19 Epidemic

et al. 2021

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“…BMI‐related test failures are not a benign outcome: They cause patient anxiety and potentially lead to multiple rounds of screening or unnecessary invasive testing, which delays patients' reproductive decision‐making and incurs associated administrative, emotional, and cost burdens. Therefore, taking measures to diminish such test failures is warranted.…”

Section: Discussionmentioning

confidence: 99%

Noninvasive prenatal screening for patients with high body mass index: Evaluating the impact of a customized whole genome sequencing workflow on sensitivity and residual risk

2019

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Objective Women with high body mass index (BMI) tend to have reduced fetal fraction (FF) during cell‐free DNA‐based noninvasive prenatal screening (NIPS), causing test failure rates up to 24.3% and prompting guidelines that recommend aneuploidy screening other than NIPS for patients with significant obesity. Because alternatives to NIPS are only preferable if they perform better, we compared the respective sensitivities at different BMI levels of traditional aneuploidy screening and a customized whole‐genome sequencing NIPS. Method The relationship between FF, aneuploidy, and BMI was quantified from 58 105 patients screened with a customized NIPS that does not fail samples because of low FF alone. Expected analytical sensitivity as a function of aneuploidy and BMI (eg, trisomy 18 sensitivity when BMI = 35) was determined by scaling the BMI‐ and aneuploidy‐specific FF distribution by the FF‐ and aneuploidy‐specific sensitivity calculated from empirically informed simulations. Results Across all classes of obesity and assuming zero FF‐related test failures, analytical sensitivity for the investigated NIPS exceeded that of traditional aneuploidy screening for trisomies 13, 18, and 21. Conclusion Relative to traditional aneuploidy screening, a customized NIPS with high accuracy at low FF and a low test‐failure rate is a superior screening option for women with high BMI.

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“…25 For example, anxiety levels in pregnant women, who reported abdominal pain and/or vaginal bleeding, decreased over time when they were given a certain diagnosis, even if this was negative, while anxiety levels increased in those who received uncertain diagnoses. 26 During pregnancy, expectant parents face several anxiety triggers: medical investigations into their and their unborn child's health, waiting for results, and some may receive uncertain diagnoses. The added uncertainty of risks brought by COVID-19 may have negatively impacted expectant parents' mood more than that of parents as the former typically experience more uncertainty and anxiety while pregnant.…”

Section: Barriersmentioning

confidence: 99%

Barriers and facilitators to mood and confidence in pregnancy and early parenthood during COVID-19 in the UK: A mixed-methods synthesis survey

Perez¹,

Panagiotopoulou²,

Curtis³

et al. 2020

Preprint

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Background: Parents’ well-being during pregnancy and early parenthood is critical for children’s development. Environmental stressors can significantly challenge parents’ well-being.Aims: To investigate how COVID-19 and associated restrictions influence mood and parenting confidence of expectant parents and those in early parenthood, identifying barriers and facilitators.Methods: We used a cross-sectional online survey to collect data from 590 expectant parents and parents of infants (564 females) during the most restrictive phase of the lockdown in the UK. Survey included a mixture of forced-choice and open-ended questions pertaining to mood, perceived social support, media use, online interactions, and parenting expectations. Quantitative data were analysed using multiple linear regression and proportional odds models, while an inductive thematic analysis was employed for qualitative data. Quantitative and qualitative data were qualitatively synthesised.Results: A decrease in mood and parenting confidence were found. Barriers included practical difficulties (finding essentials, reliable health information), social difficulties (loss of physical contact, decreased support), and uncertainty during pregnancy. Facilitators included support from others and for first-time parents, loss of childcare resulting in greater parenting confidence. While online resources and communication were not preferable to face-to-face interactions, technology was a helpful tool for communicating, getting support, and finding essentials and information during lockdown.Conclusion: By mid-May 2020, mood and parenting confidence among expectant and parents of newborns in the UK were significantly reduced. Consideration of barriers and facilitators in healthcare and psychological support provided is likely to play an important part in promoting parental mental health and healthy parent-child relationships.

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Anxiety associated with diagnostic uncertainty in early pregnancy

Cited by 37 publications

References 19 publications

Association of Stress-Related Factors With Anxiety Among Chinese Pregnant Participants in an Online Crisis Intervention During COVID-19 Epidemic

Association of Stress-Related Factors With Anxiety Among Chinese Pregnant Participants in an Online Crisis Intervention During COVID-19 Epidemic

Noninvasive prenatal screening for patients with high body mass index: Evaluating the impact of a customized whole genome sequencing workflow on sensitivity and residual risk

Barriers and facilitators to mood and confidence in pregnancy and early parenthood during COVID-19 in the UK: A mixed-methods synthesis survey

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