Anxiety and coping strategies of pregnant women and infant development in the context of prenatal ultrasound diagnostics

Ultrasound is a widespread non-invasive method of prenatal diagnosis. The detection of fetal abnormalities can provoke anxiety, which needs coping. Anxiety and the coping process of pregnant women with different risk conditions for fetal abnormality were studied in a longitudinal design and compared with a non-risk control group of women with healthy uncomplicated pregnancies. The level of anxiety and the coping strategies of women (N = 664) during the second trimester were assessed with questionnaires. Data were collected at three points in time: immediately before the ultrasound scanning for fetal malformation, 5-6 and 10-12 weeks after the prenatal ultrasound examination. Questionnaires were also used to collect information about sociodemographic data, pregnancy data and personality. The level of anxiety showed a correlation with the coping strategies. The analysis of the coping strategies of women with high-risk pregnancies (n = 497) and as well of these with no-risk conditions in the control group (n = 167) revealed three different factors of coping: Factor I: positive emotional attitude/distance, Factor II: negative emotional attitude/disapproval and Factor II: active coping. At all three points in time, Factor I correlated significantly with anxiety decrease, Factor II with increase and Factor III did not correlate with anxiety at all. Women with risk-pregnancies experienced high levels of anxiety before ultrasound scanning and used coping strategies similar to those women in the control group. Different spectrums of coping strategies corresponded significantly to increasing or decreasing anxiety. These women with high levels of anxiety should be offered psychotherapeutic counselling, as their coping processes did not lead to successful coping in the form of a reduction in anxiety. The possible impact of these results on fetal and infant development is discussed.