Takeaway
- Higher anxiety and pregnancy-specific stress were not directly associated with a longer first stage of labour duration.
- However, pregnancy-specific stress was associated with epidural use, which in turn was significantly associated with increased risk of augmentation, and longer first stage of labour.
Why this matters
- Findings suggest that pregnancy-specific stress rather than general anxiety may need to be the focus of any psychological screening in pregnancy.
Study design
- A study of 1145 pregnant primiparous women (age, ≥18 years) using data from the Wirral Child Health and Development Study.
- Antenatal anxiety and pregnancy-specific stress were evaluated at 20 weeks’ gestation using State-Trait Anxiety Inventory and Pregnancy Stress Scale score, respectively.
- Funding: UK Medical Research Council.
Key results
- Anxiety (high vs low; mean difference [MD], 13.94 minutes; 95% CI, −26.60 to 54.49) and pregnancy-specific stress (high vs low; MD, 12.05 minutes; 95% CI, −19.52 to 43.63) were not directly associated with the duration of first stage of labour.
- Anxiety (high vs low, 39% vs 31%; P=.042) and pregnancy-specific stress (high vs low, 38% vs 29%; P<.001) were associated with epidural use, which was itself linked to longer labour (MD, 158.79 minutes; 95% CI, 125.89-191.68; P<.001).
- Anxiety (OR, 1.53; 95% CI, 1.07-2.19) and pregnancy-specific stress (OR, 1.36; 95% CI, 1.02-1.81) were associated with increased risk of augmentation, but these associations were non-significant after accounting for epidural, which was itself associated with augmentation.
- Pregnancy-specific stress but not general anxiety was particularly linked to both longer labour (b=0.022; P=.015) and augmentation (b=0.137; P=.015) via indirect pathways through epidural.
Limitations
- Findings relate only to the first stage of labour and not the total labour duration.
This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.
