Past Issue

Volume 12, Number 4, Jan-Mar 2019, Pages: 329-334

Correlation of Maternal Stress Because of Positive Aneuploidy Screening Serum Analytes and Uterine Arteries’ Doppler Ultrasound Index: A Prospective Cohort Study

Mahboobeh Shirazi, M.D, 1, Parichehr Pooransari, M.D, 2, Fatemeh Rahimi Sharbaf, M.D, 1, Shirin Niromanesh, M.D, 1, Behrokh Sahebdel, M.D, 1, *, Mamak Shariat, M.D, 1, Zeinab Pahlavan, M.D, 3, Mahmoud Shirazi, Ph.D, 4, Maryam Ahmadian, M.D, 1,
Maternal, Fetal and Neonatal Research Centre, Tehran University of Medical Sciences, Tehran, Iran
Shohada Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Department of Perinatology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
Department of Psychology, University of Sistan and Baluchestan, Zahedan, Iran
*Corresponding Address: Maternal Fetal and Neonatal Research Centre Tehran University of Medical Sciences Tehran Iran



Antenatal anxiety or maternal stress is a prevalent chronic mental disorder in pregnant women. We have assessed the effect of maternal stress from positive aneuploidy screening results on the changes in uterine artery blood flow.

Materials and Methods

We performed a prospective cohort (one sample) pilot study at a hospital in Tehran, Iran. A total of 60 pregnant women who were candidates for amniocentesis due to abnormal sequential screening test results entered the study. We conducted 2 standard psychological tests, the Spielberger’s State-Trait Anxiety Inventory and the Beck Anxiety Inventory, to determine anxiety levels in the participants before amniocentesis and two weeks after amniocentesis. The uterine artery resistance index was also measured before and two weeks after amniocentesis. The level of maternal stress was compared with the uterine artery resistance index.


Patients had a mean State Trait Anxiety Inventory score before amniocentesis of greater than 40, which meant that the mothers experienced high anxiety. There were no correlations between both inventories’ anxiety scores and uterine artery blood flow before amniocentesis. However, two weeks after amniocentesis, we observed significant negative correlations between the State Anxiety (P=0.0041) and Trait Anxiety (P=0.010) Inventory scores and the uterine artery resistance indexes. Also, there was an association between the decreased right uterine artery resistance index and State Anxiety scores (P=0.036). There were significant correlations between State and Trait Anxiety scores and second trimester analytes of β-human chorionic gonadotropin (β-hCG, P<0.001), α-fetoprotein (P<0.001), and unconjugated estriol (P=0.048).


Maternal anxiety because of positive aneuploidy screening serum analytes and amniocentesis can af- fect perinatal outcomes via mood-based alterations in blood flow of the uterine arteries and the screening markers β-hCG,unconjugated estriol, and α-fetoprotein.