Effects of maternal anxiety on uteroplacental, fetoplacental and fetal circulations in low risk pregnancies

Abstract

Maternal anxiety is a very important aspect in maternal care today, and the effects that it may have on the pregnancy are poorly understood. The hypothesis is that maternal anxiety is associated with changes in the uteroplacental, placental and fetal circulations in the third trimester. Objectives: To evaluate the association between maternal anxiety and changes in uteroplacental, fetoplacental and fetal circulations, in low-risk pregnant women in the third trimester. Methods: This study will be a cross-sectional study, collecting data in a prospectively way. Pregnant women with the following criteria will be included: single and live fetus; maternal age between 18 and 34 years; without comorbidities or complications; nonsmokers and that do not report alcohol consumption; in the absence of regular medication use; gestational age between 34 and 40 weeks; level of education that allows to understand the anxiety scale. It will be applied the Beck Anxiety Inventory (BAI). After this step, the Dopplervelocimetry studies of the uterine, umbilical, fetal middle cerebral arteries and umbilical vein will be performed. According to the sum of the scores obtained on the scale of BAI, constituted of 21 items, anxiety will be classified as minimal from 0 to 10, light 11-21, moderate 22-30 and high from 31 to 63. The doppler will be performed with ultrasound device with color flow mapping. All Doppler measurements will be obtained in the fetal period of inactivity. The pulsatility indices, the systole/diastole relation, the flow volume and volume flow corrected for the estimated fetal weight will be analyzed. According to the sample size calculation, we intended to recruit 30 pregnant women for the study. It will be held the analysis of comparative and quantitative variables, and made a comparison between the proportions by Qui-square test or Fisher exact test, and the comparison between continuous variables by t student test or Mann Whitney U. The correlation analysis will be completed by Spearman Correlation or rank test. The level of significance will be p <0.05.