Effects of Pregnancy Specific Anxiety on Pregnancy outcome and Serum Cortisol levels during Third Trimester of Pregnancy

Abstract

Objectives: To evaluate the effects of Pregnancy Specific Anxiety on Pregnancy outcome and
serum Cortisol levels.
Methods: This study was conducted during February to July 2022 at the “Department of
Gynecology” (Opd/ward) of LUMHS Jamshoro/Hyderabad. This was a “Cross-sectional,
observational Study”. 227 women in their 3rd trimester with singleton pregnancy age 25-38
years were included in this study. Pregnant women with the condition of essential hypertension,
women already on anti-hypertensive therapy, not attended regular antenatal care follow-ups, anti
-depression / anti-psychotic, and those who had endocrinological disorders were excluded.
Serum Cortisol level (nmol/L) was assessed early morning level between 8 to 11am in fasting
state. Anxiety was assessed with “The Hamilton Anxiety Scale (HAMA)”. Pregnancy outcomes
i.e. pre-eclampsia, low birth weight and head-circumference of infant were reported.
Results: Average age of the pregnant women was 27.83+/-5.43 years. Mean serum Cortisol level
(nmol/L) was 369.36+/-175 (nmol/L). Hamilton anxiety scale score was 23.04+/-8.6. Mean birth
weight was 2.76+/-0.74 Kgs. Head circumferences (cm) was 33.61+/-1.05 cm of infants.
Majority of them were Multiparous 131(57.7%). Majority of women 70% diagnosed with
pregnancy related anxiety in their 3rd trimester. Correlation between Cortisol level and anxiety
score showed significant and positive correlation (r=0.58; P= 0.000).
Conclusion: The results demonstrated the prevalence of pregnancy specific anxiety and its
effects of on cortisol levels in pregnant women during 3rd trimester. Additionally, we discovered
evidence of long-term effects of psychological indicators of anxiety or cortisol on pregnancy
outcomes i.e. lower birth weight. 70% of the study participants reported having anxiety. In order
to avoid associated negative pregnancy outcomes, it is essential to investigate and manage
pregnancy-specific anxiety during routine prenatal care.
Keywords: Maternal anxiety, Cortisol level, third trimester, pregnancy, birth weight, adverse
outcomes, neonates, Hamilton anxiety scale.