Trial reportBrain, behavior, and immunity2024
The immune phenotype of perinatal anxiety in an anxiety-focused behavioral intervention program in Pakistan.
Trial report in Brain, behavior, and immunity, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04566861 (Biological Processes Underlying Anxiety During Pregnancy), which is not on this map. Cited by 5 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Biological Processes Underlying Anxiety During Pregnancy: A Substudy of an Anxiety-focused Early Prenatal Intervention for the Prevention of Common Mental Disorders in Pakistan
Who cites it
5 citing papers in PubMed.
- Integrating mental health into obstetric practice: a review of collaborative care models for perinatal anxiety.Journal of perinatal medicine · 2026Review
- Biopsychosocial stressors and perinatal mental health: The mediating role of social support in a Pakistani cohort.Global mental health (Cambridge, England) · 2026Article
- Biomarkers of reproductive psychiatric disorders.The British journal of psychiatry : the journal of mental science · 2025Review
- Association of preoperative anxiety and depression with quality of recovery after caesarean delivery: a prospective observational study.JA clinical reports · 2025Article
- Validation of the Japanese Version of Obstetric Quality of Recovery-11 Questionnaire and Its Association with Postpartum Depression and Functional Outcomes: A Prospective Observational Study.Journal of clinical medicine · 2025Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundDysregulation of the immune system has been associated with psychiatric disorders and pregnancy-related complications, such as perinatal depression. However, the immune characteristics specific to perinatal anxiety remain poorly understood. In this study, our goal was to examine specific immune characteristics related to prenatal anxiety within the context of a randomized controlled trial designed to alleviate anxiety symptoms-the Happy Mother - Healthy Baby (HMHB) study in Rawalpindi, Pakistan. MATERIALS AND
methodsPregnant women (n = 117) were followed prospectively in the 1st, 2nd, and 3rd trimesters (T1, T2, T3) and at 6 weeks postpartum (PP6). Each visit included a blood draw and anxiety evaluation (as measured by the anxiety subscale of the Hospital Anxiety and Depression Scale - HADS -using a cutoff ≥ 8). We enrolled both healthy controls and participants with anxiety alone; those with concurrent depression were excluded.
resultsK-means cluster analysis revealed three anxiety clusters: Non-Anxiety, High and Consistent Anxiety, and Decreasing Anxiety. Principal components analysis revealed two distinct clusters of cytokine and chemokine activity. Women within the High and Consistent Anxiety group had significantly elevated chemokine activity across pregnancy (in trimester 1 (β = 0.364, SE = 0.178, t = 2.040, p = 0.043), in trimester 2 (β = 0.332, SE = 0.164, t = 2.020, p = 0.045), and trimester 3 (β = 0.370, SE = 0.179, t = 2.070, p = 0.040) compared to Non-Anxiety group. Elevated chemokine activity was associated with low birthweight (LBW) and small for gestational age (SGA).
conclusionOur findings reveal a unique pattern of immune dysregulation in pregnant women with anxiety in a Pakistani population and offer preliminary evidence that immune dysregulation associated with antenatal anxiety may be associated with birth outcomes. The dysregulation in this population is distinct from that in our other studies, indicating that population-level factors other than anxiety may play a substantial role in the differences found. (Clinicaltrials.gov # NCT04566861).
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