The impact of second trimester detailed ultrasonography on anxiety and depression in high and low risk pregnancy

BACKGROUND: The objective of this study was to assess the impact of second trimester ultrasonographic anatomy screening on anxiety and depression levels in pregnant women at high and low-risk and to investigate other factors influencing these scores. METHODS: This observational prospective study included pregnant women admitted for second-trimester fetal anatomy screening. The patients were categorized into three groups based on their pregnancy risk status, low-risk, maternal-placental risk, or fetal risk. Anxiety and depression levels were evaluated using the Spielberger's State-Trait Anxiety Inventory (STAI) and Edinburgh Postpartum Depression Scale (EPDS) before and one month after the scan. Inter-group comparisons were performed using the Kruskal-Wallis test, intra-group changes via the Wilcoxon signed-rank test, and risk factors via binary logistic regression. RESULTS: A total of 136 pregnant women (low-risk: n = 55; maternal-placental risk: n = 40; fetal risk: n = 41) were included in the final analysis. No significant inter-group differences in anxiety and depression scores were found either before or after ultrasonography. However, state and trait anxiety scores (STAI-S and STAI-T) significantly decreased within the low-risk group (p = 0.011, p = 0.028) and the fetal risk group (p = 0.002, p = 0.023) after the scan. Multivariate logistic regression revealed that maternal-placental risk (odds ratio [OR]: 11.6, p = 0.002), a history of fetal structural anomaly or preeclampsia (OR: 8.6, p = 0.023), and higher maternal age (OR:1.1, p = 0.015) were significant predictors of high state anxiety after ultrasound. CONCLUSION: Second-trimester ultrasonography reduces anxiety in the low-risk and fetal risk groups. Conversely, women with maternal-placental diseases, a history of obstetric complications, or higher maternal age are at higher risk for persistent anxiety and should be considered for specialized counseling or psychological support to ensure a comprehensive evaluation of mental health.