Pregnancy-related Anxiety In The Second And Third Trimester And Children's Neuropsychological Development At 6 Months And 18 Months:A Birth Cohort Study

ObjectivesThis study aims to determine the associations and strengths between pregnancy-related anxiety in the second and third trimester and children's neuropsychological development at 6 months and 18 months.MethodsA prospective cohort study was conducted in Ma'anshan,Anhui province,China.A total of 3,474 eligible pregnant women within 14 weeks of gestation were recruited.The information about demographic characteristics of pregnants was collected in early pregnancy.The completed self-made scale of pregnancy-related anxiety was asked to return in the second and third trimester to assess pregnant pregnancy-related anxiety.The evaluation criterion of pregnancy-related anxiety was recorded as greater than or equal to P₇₅ of total score.The information about fetal body weight,body length,head circumference,chest circumference was collected after delivery.The scale of Ages and Stages Questionnaire of China which assessing children's neuropsychological development was completed at 6 months and 18 months.Logistic regression model was conducted to evaluate the associations between pregnancy-related anxiety in the second and third trimester and children's neuropsychological development at 6 months and 18months.ResultsA total of 2,609 mother-child pairs were included in final analysis,The rate of pregnancy-related anxiety was 29.0%in the second trimester and 30.4%in the third trimester.At 6 months,the rate of mild developmental delay was 12.8%in gross motor domain,9.8%in fine motor domain,11.5%in communication domain,9.4%in problem-solving domain and 15.9%in personal-social domain;the rate of severe development delay was 4.8%in gross motor domain,4.5%in fine motor domain,3.5%in communication domain,5.1%in problem-solving domain and 3.5%in personal-social domain.At 18 months,the rate of mild developmental delay was 15.5%in gross motor domain,6.4%in fine motor domain,18.9%in communication domain,12.8%in problem-solving domain and 9.4%in personal-social domain;the rate of severe development delay was 3.1%in gross motor domain,6.3%in fine motor domain,2.1%in communication domain,3.5%in problem-solving domain and 3.4%in personal-social domain.Analysis of univariate logistic regression between pregnancy-related anxiety in the second and third trimester and children's neuropsychological development at 6 months and 18 months showed that,pregnancy-related anxiety in the third trimester increased the risk of mild developmental delay in gross motor?OR=1.31,95%CI:1.03¹.67?,severe development delay in communication?OR=1.81,95%CI:1.19².76?and severe development delay in personal-social?OR=1.98,95%CI:1.09³.61?at 6 months;pregnancy-related anxiety in the second trimester increased the risk of severe development delay in fine motor?OR=1.40,95%CI:1.01¹.96?and severe development delay in problem-solving?OR=1.88,95%CI:1.23².87?at 18 months;pregnancy-related anxiety in the third trimester increased the risk of mild developmental delay in gross motor?OR=1.32,95%CI:1.06¹.65?,meanwhile,increased the risk of mild developmental delay?OR=1.37,95%CI:1.08¹.75?and severe developmental delay?OR=2.37,95%CI:1.56³.61?in problem-solving at 18 months.After controlling potential confounding factors,logistic regressions showed that,at 6 months,pregnancy-related anxiety in the third trimester increased the risk of severe development delay in communication?OR=3.18,95%CI:1.79⁵.64?,pregnancy-related anxiety in the second and third trimester increased the risk of mild developmental delay in gross motor?OR=1.36,95%CI:1.02¹.82?.At 18 months,pregnancy-related anxiety in the third trimester increased the risk of severe development delay in fine motor?OR=1.80,95%CI:1.10².93?,pregnancy-related anxiety in the second and third trimester increased the risk of mild developmental delay in gross motor?OR=1.33,95%CI:1.01¹.74?,meanwhile,increased the risk of severe development delay in fine motor?OR=1.50,95%CI:1.01².22?and problem-solving?OR=2.50,95%CI:1.54⁴.06?.ConclusionOverall,our findings showed that pregnancy-related anxiety in the second trimester was not significantly associated with children's neuropsychological development at 6and 18 months;pregnancy-related anxiety in the third trimester and pregnancy-related anxiety in the second and third trimester was related to children's neuropsychological development at 6 months and 18 months.The effect of pregnancy-related anxiety in the second and third trimester on children's neuropsychological development at 18 months was more serious than at 6 months...