ArticleActa obstetricia et gynecologica Scandinavica2021
Do stress and anxiety in early pregnancy affect the progress of labor: Evidence from the Wirral Child Health and Development Study.
Article in Acta obstetricia et gynecologica Scandinavica, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 22 citations in OpenAlex.
- Mindfulness-based stress reduction intervention during pregnancy changes maternal brain.Scientific reports · 2025Trial
- Psychometric and clinical validation of the fear of childbirth questionnaire in a UK population.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Racial and Ethnic Differences in Labor Duration and Cesarean Indications Among Low-Risk Nulliparous Term Singleton Vertex Births: A Retrospective Analysis.Journal of clinical medicine · 2026Article
- Maternal Inner Strength Mediates the Longitudinal Association Between Family Emotional Expression and Fear of Childbirth: A Cross-Lagged Panel Mediation Analysis.International journal of women's health · 2026Article
- Experiencing weight stigma during childbirth increases the odds of cesarean birth.BMC pregnancy and childbirth · 2025Article
- Autoimmune Thyroid Disease and Pregnancy: The Interaction Between Genetics, Epigenetics and Environmental Factors.Journal of clinical medicine · 2024Review
- When pregnancy and pandemic coincide: changes in stress and anxiety over the course of pregnancy.Journal of reproductive and infant psychology · 2024Article
- Maternal Stress, Anxiety, Well-Being, and Sleep Quality in Pregnant Women throughout Gestation.Journal of clinical medicine · 2023Article
- The Effects of Virtual Reality in Maternal Delivery: Systematic Review and Meta-analysis.JMIR serious games · 2022Review
- Does the COVID-19 Pandemic Affect Labor-Related Anxiety and Prevalence of Depressive Symptoms in Pregnant Women?Journal of clinical medicine · 2022Article
- Article
- Do stress and anxiety in early pregnancy affect the progress of labor: Evidence from the Wirral Child Health and Development Study.Acta obstetricia et gynecologica Scandinavica · 2021Article
Corrections and comments
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Authors and funding
10 authors at 6 institutions in 1 country.
Funding
Abstract
introductionDespite widespread belief that anxiety causes longer labor, evidence of association is inconsistent. Data gathered as part of a prospective epidemiological longitudinal study were used to investigate associations between antenatal anxiety and pregnancy-specific stress, and labor progression was assessed by duration and use of augmentation. MATERIAL AND
methodsPregnant primiparous women completed measures for anxiety and pregnancy-specific stress at 20 weeks' gestation (n = 1145). Birth outcome data were extracted from medical records. Regression analyses and a path analysis assessed associations between antenatal anxiety and pregnancy-specific stress, and indices of labor progression (labor duration and augmentation).
resultsAnxiety/pregnancy-specific stress were not directly associated with duration of stage 1 labor (HIGH/LOW anxiety: mean difference = 13.94 minutes, SD = 20.66, 95% CI -26.60 to 54.49, P < .50)/(HIGH/LOW pregnancy-specific stress: mean difference = 12.05 minutes, SD = 16.09, 95% CI -19.52 to 43.63, P < .45). However, anxiety/pregnancy-specific stress were associated with epidural use (HIGH/LOW anxiety: 39% vs 31%, P < .042; HIGH/LOW pregnancy-specific stress: 38% vs 29%, P < .001), which was itself associated with longer labor (mean difference: 158.79 minutes, SD = 16.76, 95% CI 125.89-191.68, P < .001). Anxiety and pregnancy-specific stress were associated with increased likelihood of augmentation but these associations were nonsignificant after accounting for epidural, which was itself highly associated with augmentation. However, path analysis indicated an indirect effect linking pregnancy-specific stress, but not general anxiety, to labor duration and augmentation: elevated pregnancy-specific stress led to greater use of epidural, which was linked to both increased rates of augmentation, and increased labor duration.
conclusionsContrary to general belief, general anxiety and specific pregnancy stress were not directly linked to longer duration of stage one labor. However specific pregnancy stress was associated with epidural use, which in turn was significantly associated with risk of augmentation, and longer stage one labor. Identification of pregnancy-specific stress could help to identify women for whom psychological interventions could improve birth experience.
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