Factors associated with state and trait anxiety in women hospitalised for threatened preterm labour: a biopsychosocial 4Ps-informed analysis

Background Hospitalisation for threatened preterm labour (TPL) may be accompanied by anxiety. This secondary analysis examined correlates of state and trait anxiety using a biopsychosocial 4Ps-informed organisational framework (predisposing, precipitating/clinical-context, candidate perpetuating and putative protective domains). Methods Cross-sectional data were obtained from 213 women hospitalised for TPL at 22–37 weeks' gestation in Poland. Participants completed the State–Trait Anxiety Inventory, Berlin Social Support Scales and Courtauld Emotional Control Scale. Hierarchical linear regressions entered sociodemographic and reproductive characteristics, gestational age and non-overlapping psychosocial measures in three blocks. Results High state- and trait-anxiety scores were observed in 39.0% and 8.0% of participants, respectively. The state-anxiety model had R 2 = 0.401 and adjusted R 2 = 0.358; the psychosocial block contributed ΔR 2 = 0.158 ( p < 0.001). Professional activity and a less favourable subjective financial situation were associated with higher state anxiety, emotional support with lower state anxiety, and protective buffering support with higher state anxiety. The trait-anxiety model had R 2 = 0.614 and adjusted R 2 = 0.587; the psychosocial block contributed ΔR 2 = 0.297 ( p < 0.001). Higher education, gravidity and instrumental support were associated with lower trait anxiety; professional activity, a less favourable subjective financial situation, unplanned pregnancy, protective buffering support and emotional suppression were associated with higher trait anxiety. Gestational age was not significant in either final model. Conclusions Structural and psychosocial variables were associated with anxiety during TPL hospitalisation. Associations with support dimensions differed in direction. The cross-sectional findings do not establish protective effects, causal pathways or statistically distinct correlates of state and trait anxiety.