Testing a new questionnaire to screen for anxiety in pregnancy - V1

• Research type

  Research Study

• Full title

  The development and initial validation of a screening scale for antenatal anxiety

• IRAS ID

  200130

• Contact name

  Andrea Sinesi

• Contact email

  andrea.sinesi@stir.ac.uk

• Sponsor organisation

  University of Stirling

• Duration of Study in the UK

  2 years, 2 months, days

• Research summary

  Summary of Research
  This study aims to develop and test a questionnaire to screen for anxiety in pregnant women. During pregnancy, a substantial minority (around one in seven) of women develop significant clinical anxiety that can have a negative effect on long-term health and well-being of mothers and babies. Many questionnaires are available to screen for postnatal depression, but recent reviews indicate that no reliable screening tools have been developed to distinguish between significant clinical anxiety and the normal anxieties and worries women may experience during pregnancy. Initially, a review of the literature will examine a range of existing anxiety measures. Involvement of women with experience of poor perinatal mental health and mental health professionals will further support the development of this new screening scale. In order to test whether the new scale is effective for use in pregnancy, 200 women will be recruited from antenatal clinics in Glasgow and asked to complete the new anxiety measure and the questionnaire currently recommended to identify pregnant women experiencing anxiety (GAD-7). 60 of these women will also have a clinical assessment by a mental health professional and we will compare how the new scale and the currently used scale perform compared to expert assessment. A short and reliable questionnaire would be highly valuable, assisting midwives and other health professionals, to recognise when pregnant women would benefit from further support and to aid appropriate targeting of mental health interventions.

  Summary of Results
  Anxiety in pregnancy (antenatal anxiety) is common, affecting approximately 15% of all pregnant women. Antenatal anxiety considerably increases the risk of postnatal depression and can negatively affect child development. Currently pregnant women experiencing problematic anxiety symptoms often go unrecognised and consequently do not receive any form of support or treatment. Our aims were to:

  Develop a short and reliable questionnaire that midwives and other health professionals can use to identify women with elevated levels of anxiety during pregnancy Test how accurate and reliable this new screening scale is by comparing it to expert assessment Determine whether pregnant women consider the questionnaire acceptable for use in routine antenatal care

  KEY FINDINGS
  we found that the new antenatal anxiety scale showed very good screening accuracy (sensitivity=91%; specificity=85%). We also found that the Generalised Anxiety Disorder-2 (GAD-2), the scale currently recommended by the National Institute for Health and Care Excellence (NICE) to screen for antenatal anxiety, performed worse than the new antenatal anxiety scale in identifying women with an anxiety disorder. The GAD-2, at the cut-off score (i.e. the score on a scale used to distinguish “cases” from “non-cases”) currently recommended by NICE, showed a sensitivity of 27% and a specificity of 96%. This means that while the GAD-2 was excellent in identifying correctly women who did not have an anxiety disorder, it only identified correctly 27% of women with an anxiety disorder.
  The ease of completion and acceptability of the new scale to pregnant women was also assessed. The scale was judged to be easy to complete and acceptable, with average scores above 9 using a scale from 1 to 10 in which 10 indicated that the scale was “extremely easy” to complete and “completely acceptable” for use in routine maternity care

• REC name

  South East Scotland REC 02

• REC reference

  16/SS/0131

• Date of REC Opinion

  1 Aug 2016

• REC opinion

  Favourable Opinion