Responsiveness of the Japanese version of the Pregnancy-Related Anxiety Questionnaire-Revised 2 and its predictive validity for postnatal maternal mental health: A longitudinal study in Japan

Aim

The extent to which pregnancy-related anxiety predicts postnatal maternal mental health remains unclear. This study aimed to evaluate the responsiveness and predictive validity of the Japanese version of the Pregnancy-Related Anxiety Questionnaire-Revised 2 in identifying women at high risk for postnatal mental health problems.

Methods

A longitudinal study recruited 218 Japanese women in early pregnancy from three facilities and followed them through the postpartum period. Participants completed the scale three times (in early, mid-, and late pregnancy). Responsiveness was analyzed using one-way repeated measures Analysis of Variance. At 1 month postpartum, the Parenting Stress Index and the Edinburgh Postnatal Depression Scale assessed parenting stress and depression. Spearman's correlations were calculated between the scale and parenting stress, and Receiver Operating Characteristic curves examined its predictive validity for depression.

Results

A total of 211 women were followed up. The scale scores were highest in early pregnancy (p < 0.001). Spearman's correlation coefficients between pregnancy-related anxiety and postnatal parenting stress ranged from 0.34 to 0.43 across the pregnancy stages. Areas under the curve for predicting postnatal depression were 0.74 (early), 0.79 (mid-), and 0.77 (late pregnancy). Based on the set threshold, women with high scale scores had significantly increased relative risks (95% confidence intervals) of postnatal depression: 3.4 (1.4–8.2) (early), 5.2 (2.5–10.7) (mid-), and 6.9 (2.7–18.0) (late pregnancy).

Conclusions

This scale showed good responsiveness and predictive validity, making it a valuable tool for identifying women at risk of postnatal mental health issues and evaluating intervention efficacy in clinical settings.