A psychometric systematic review of self-report instruments to identify anxiety in pregnancy

Evans, Kerry, Spiby, Helen and Morrell, C. Jane (2015) A psychometric systematic review of self-report instruments to identify anxiety in pregnancy. Journal of Advanced Nursing, 71 9: 1986-2001. doi:10.1111/jan.12649

Author Evans, Kerry
Spiby, Helen
Morrell, C. Jane
Title A psychometric systematic review of self-report instruments to identify anxiety in pregnancy
Journal name Journal of Advanced Nursing   Check publisher's open access policy
ISSN 1365-2648
Publication date 2015-03-26
Year available 2015
Sub-type Article (original research)
DOI 10.1111/jan.12649
Volume 71
Issue 9
Start page 1986
End page 2001
Total pages 16
Place of publication Chichester, United Kingdom
Publisher Wiley-Blackwell Publishing Ltd
Language eng
Formatted abstract

To report a systematic review of the psychometric properties of self-report instruments to identify the symptoms of anxiety in pregnancy to help clinicians and researchers select the most suitable instrument.


Excessive anxiety in pregnancy is associated with adverse birth outcomes, developmental and behavioural problems in infants and postnatal depression. Despite recommendations for routine psychological assessment in pregnancy, the optimal methods to identify anxiety in pregnancy have not been confirmed.


Psychometric systematic review.

Data sources

A systematic literature search of the multiple databases (1990–September 2014).

Review methods

Identification of self-report instruments to measure anxiety in pregnancy using COSMIN guidelines to assess studies reporting a psychometric evaluation of validity and reliability.


Thirty-two studies were included. Studies took place in the UK, Australia, Belgium, Canada, Germany, Italy, Scandinavia, Spain and the Netherlands. Seventeen different instruments were identified. Measures of validity were reported in 19 papers and reliability in 16. The overall quality of the papers was rated as fair to excellent using the COSMIN checklist. Only one paper scored excellent in more than one category.


Many instruments have been adapted for use in different populations to those for which they were designed. The State Trait Anxiety Inventory, Edinburgh Postnatal Depression Scale and the Hospital Anxiety and Depression Scale have been tested more frequently than other instruments, yet require further assessment to confirm their value for use in pregnancy.
Keyword Antenatal care
Psychometric systematic review
Psychometric testing
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Nursing, Midwifery and Social Work Publications
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Citation counts: TR Web of Science Citation Count  Cited 5 times in Thomson Reuters Web of Science Article | Citations
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