Risk and protective factors for pregnancy-related anxiety. An ecological perspective

Abstract Pregnancy-related anxiety is a distinct form of anxiety characterized by concerns specific to pregnancy, such as maternal and fetal well-being and healthcare experiences. This study examines the risk and protective factors for pregnancy-related anxiety using an ecological framework. The sample consisted of 219 pregnant women, with data collected by online survey. Hierarchical regression analysis assessed the impact of sociodemographic factors, enduring traits, and situational factors on pregnancy-related anxiety. The findings indicate that increasing age, lower self esteem, greater self-coldness, and exposure to intimate partner violence are significant predictors of pregnancy-related anxiety. Contrary to some previous research, ethnicity, education, employment, and financial stress and antenatal care were not significant predictors after accounting for other variables. The study highlights the importance of screening for pregnancy-related anxiety and intimate partner violence (IPV) in antenatal care, as well as the potential benefits of interventions aimed at improving self-compassion and self-esteem to mitigate this anxiety. These results underscore the need for comprehensive assessment tools that capture the breadth of pregnancy-related fears and concerns and for targeted interventions to support pregnant women at risk of anxiety. By addressing previous limitations related to the categorical and narrow assessment of pregnancy-related anxiety, this study provides a more nuanced understanding of its predictors and implications. Practical implications include universal screening of pregnancy-related anxiety and IPV in healthcare settings and the development of therapeutic interventions such as compassionate mind training to enhance self-compassion and self-esteem and skin-to-skin care. Future research should explore longitudinal designs to establish causal relationships and further investigate the role of protective factors in pregnancy-related anxiety.