Some effects of maternal anxiety on the fetus and on pregnancy outcome

Abstract: The aim of this thesis was to study maternal emotional impact on the fetus and on pregnancy outcome. The thesis comprises five papers, which emanate from a prospective study regarding life situation, the experience of pregnancy, anxiety (Spielberger State-Trait Anxiety),and life events in nulliparous women, conducted in Malmö during 1988-1989. Examinations of fetal hemo-dynamics, fetal movements, and fetal heart rate(FHR) patterns were performed. In all women gestional age was estimated on the basis of ultrasound fetometry at around 18 gestational weeks (gws). Fetuses of women with high trait- anxiety scores had significantly higher PI-values in the fetal umbilical arertery and significantly lower PI in the fetal middle cerebral artery, and significantly lower cerebro-umbilical PI ratios, suggesting a change in blood flow distribution in favour of the fetal brain. There was no relationship between the number and type of (life areas) of life events six months before before pregnancy to 25 gws and gestational age at delivery. A non-significant relationship (p= 0.06) was found between shorter pregnancy duration and the number of potentially stressful life events (important, negative, uncontrollable) that had occurred during the entire study period. No associations were found between maternal state- and trait- anxiety and baseline FHR or the percentage time the fetus spent moving during any FHR pattern.The duration of FHR pattern D and the variability in FHR pattern D increased with increasing maternal state and trait anxiety. No statistically significant relationships were found between maternal state or trait anxiety and the degree of agreement between the maternally perceived and sonographically recorded fetal movements during any FHR pattern. Worry reported at mid-pregnancy was associated with a significantly longer duration of the active phase of labour. Women who worried about the child´s condition and care had a significantly longer duration of the active phase of labour. To be worried of becoming ill because of pregnancy or bodily harmed during delivery, and to have a negative attitude towards delivery was associated with a significantly shorter expulsory phase of labour.