Anxiety and Uterine Artery Doppler Flow in A Population of Pregnant Women of High Risk Down Syndrome Fetus: A Prospective Cohort Study

Document Type : Original Article


1 Department of Obstetrics and Gynecology Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran

2 Maternal Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran

3 Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA

4 Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran

5 Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran

6 Department of Psychology, University of Sistan and Baluchestan, Zahedan, Iran

7 Department of Clinical Research Development, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

8 Department of Psychology, Tehran University of Medical Sciences, Tehran, Iran

9 Brain and Spinal cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran

10 Department of Obstetrics and Gynecology, Mashhad University of Medical Sciences, Mashhad, Iran


Background: Fetal exposure to maternal anxiety is associated with low birth weight and maternal stress may be led to constriction of uterine arteries. This study compared the relation of anxiety and uterine artery doppler flow indices in pregnant women with the high and low-risk of Down syndrome.
Materials and Methods: This prospective cohort study was conducted among pregnant women in the second trimester that were classified as having a high or low risk according to their prenatal aneuploidy screening outcome. The high risk group underwent amniocentesis. Anxiety was initially assessed using the Spielberger State-Anxiety Inventory (STAI) and uterine artery blood flow indices were evaluated 2 times for the both groups. For the high-risk group first: immediately before amniocentesis and second: after two weeks follow up, when receiving the karyotype results and for the low-risk group in the first admission and two weeks later.
Results: Totally, 375 pregnant women participated in our study that sorted into 2 risk populations based on the aneuploidy screening test, low-risk=176 and high-risk women=199. The high-risk group for Down syndrome amniocentesis showed abnormal results in the 23 cases (23/199). The mean state (P=0.003) and trait (P=0.033) of the Anxiety Inventory scores were significantly different between the groups. Baseline uterine artery indices were no significant difference between the groups. Baseline Uterine artery indices in the high-risk group was significantly different with follow-up (in both positive-amniocentesis and negative amniocentesis sub-groups) indices. Also, there was a weak and significant correlation in the uterine resistance index and STAI scores (P=0.008, r=0.137) during the follow-up period.
Conclusion: All pregnant women experienced high level anxiety, especially in the high-risk group that may reduce after confirmation of prenatal aneuploidy screening test and also affects the Doppler indices. For all pregnant women; Stress management and emotional support training is recommended before and during pregnancy.


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