The Prevalence and Predictors of Reported Prenatal Anxiety Among Primigravid Individuals in Nova Scotia

Prenatal anxiety affects 10%-20% of pregnant Canadians and is linked to adverse maternal and neonatal outcomes. This study aimed to determine the prevalence of reported prenatal anxiety among primigravid persons with singleton pregnancies in Nova Scotia from 2004 to 2023 and explore potential predictors of reported prenatal anxiety, including birth year group, age, partner status, education level, pre-pregnancy BMI, smoking, and cannabis use.

A retrospective cohort study was conducted using the Nova Scotia Atlee Prenatal Database. The study sample consisted of 53 852 primigravid persons with singleton pregnancies.

The overall prevalence of reported prenatal anxiety was 8.9%, rising significantly over time (χ² = 3513.5(3), P < 0.001) from 1.2% in the 2004-2008 period to 21.8% in the 2019-2023 period. The bivariate analyses showed significant associations between reported anxiety and all variables. In the adjusted logistic regression, the absence of a partner, lower education level, BMI ≥30.0 kg/m², smoking, and cannabis use were all independent predictors of reported prenatal anxiety, collectively explaining 17.5% of variance.

Reported prenatal anxiety among primigravid persons in Nova Scotia increased markedly over 2 decades and is associated with multiple sociodemographic factors. These findings highlight the importance of targeted screening and interventions to support pregnant persons at risk of prenatal anxiety.