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Medical/Surgical/Diseases/Complications

Poster Session 1

(162) Anxiety trends during pregnancy

Tuesday, February 13, 2024
10:30 AM – 12:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: National guidelines recommend that treatment for perinatal mood and anxiety disorders be equitably available to all pregnant individuals, however, the trend of anxiety symptomology across gestation is not known. Our aim was to examine trends in anxiety scores over time throughout pregnancy among underserved patients living in an urban community.

Study Design: This was a secondary analysis of a prospective observational study of system-based Generalized Anxiety Disorder 7-item screening questionnaire (GAD-7). The setting was a neighborhood-based community clinic in a large, urban health system that serves medically-indigent patients. GAD-7 screening was initiated at the first prenatal visit and repeated during prenatal care visits with those having two or more GAD-7 screens included in the analysis. Patients with multiple gestations, congenital anomalies, or those who established care after 34 weeks were excluded. To examine GAD-7 scores during gestation, linear regression was used for patients with multiple GAD-7 scores to calculate the direction of change over pregnancy course with P < 0.05 considered significant.

Results: Between Sept 2020 and Dec 2022, a total of 1197 patients completed serial GAD-7 screens (range: 2-6) during the antepartum period. Mean GAD-7 scores were highest at the first prenatal visit, with an average score of 4.0 (CI 3.8, 4.2) at 10 weeks gestation. The highest percentage of GAD-7 scores > 10 were observed at 14 weeks gestation (17.4%) as shown in Figure 1a. When evaluating the trend of GAD-7 over time, scores down-trended during pregnancy course as shown in Figure 1b (p-value for slope < 0.001).

Conclusion: Anxiety symptomatology is highest in the first trimester and down-trends over the pregnancy course. These findings support GAD-7 screening early in pregnancy.