The impact of second trimester detailed ultrasonography on anxiety and depression in high and low risk pregnancy.

BACKGROUND

The objective of this study was to assess the impact of second trimester ultrasonographic anatomy screening on anxiety and depression levels in pregnant women at high and low-risk and to investigate other factors influencing these scores.

METHODS

This observational prospective study included pregnant women admitted for second-trimester fetal anatomy screening. The patients were categorized into three groups based on their pregnancy risk status, low-risk, maternal-placental risk, or fetal risk. Anxiety and depression levels were evaluated using the Spielberger's State-Trait Anxiety Inventory (STAI) and Edinburgh Postpartum Depression Scale (EPDS) before and one month after the scan. Inter-group comparisons were performed using the Kruskal-Wallis test, intra-group changes via the Wilcoxon signed-rank test, and risk factors via binary logistic regression.

RESULTS

A total of 136 pregnant women (low-risk: n = 55; maternal-placental risk: n = 40; fetal risk: n = 41) were included in the final analysis. No significant inter-group differences in anxiety and depression scores were found either before or after ultrasonography. However, state and trait anxiety scores (STAI-S and STAI-T) significantly decreased within the low-risk group (p = 0.011, p = 0.028) and the fetal risk group (p = 0.002, p = 0.023) after the scan. Multivariate logistic regression revealed that maternal-placental risk (odds ratio [OR]: 11.6, p = 0.002), a history of fetal structural anomaly or preeclampsia (OR: 8.6, p = 0.023), and higher maternal age (OR:1.1, p = 0.015) were significant predictors of high state anxiety after ultrasound.

CONCLUSION

Second-trimester ultrasonography reduces anxiety in the low-risk and fetal risk groups. Conversely, women with maternal-placental diseases, a history of obstetric complications, or higher maternal age are at higher risk for persistent anxiety and should be considered for specialized counseling or psychological support to ensure a comprehensive evaluation of mental health.