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Exclusion criteria were excessive alcohol or drug use and cardiovascular disease. People with pregnancy loss, incomplete questionnaires and loss to follow\u2010up were excluded from analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Participants were enrolled before 14\u2010weeks' gestation, with follow\u2010up assessments of AS every 4\u2009weeks until delivery. Anxiety symptoms were assessed every trimester by the Beck Anxiety Inventory and by self\u2010reported history of emotional disorders (anxiety\/depression).<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>AS and wave reflection parameters, primarily carotid\u2010femoral pulse wave velocity and preeclampsia diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 235 individuals recruited, 161 were included in this secondary analysis. Baseline anxiety symptoms were present in 35.4% of participants. Anxiety was associated with a significant increase in carotid\u2010femoral pulse wave velocity across gestation, which persisted after adjustments for relevant confounders, in a combined mixed\u2010effects model (<jats:italic>B<\/jats:italic>\u2009=\u20090.27, 95% confidence interval [CI]\u2009=\u20090.008\u20130.530, <jats:italic>p<\/jats:italic>\u2009=\u20090.04). A severity\u2010response relationship was observed, where greater anxiety severity correlated with higher AS. Twelve participants (7.5%) developed preeclampsia. The association between anxiety and preeclampsia risk showed a non\u2010significant trend (odds ratio [OR]\u2009=\u20092.77, 95% CI\u2009=\u20090.84\u20139.18). However, a history of emotional disorders significantly elevated preeclampsia risk (OR\u2009=\u20093.91, 95% CI\u2009=\u20091.14\u201313.40), independent of other risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Anxiety in high\u2010risk pregnancies is associated with increased AS in a severity\u2010response manner, and may be associated with preeclampsia risk. Integrating psychological health assessments with traditional obstetric evaluations could enhance the prediction and management of maternal complications.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.18325","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T07:30:03Z","timestamp":1754638203000},"page":"1833-1843","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Anxiety and Arterial Stiffness in High\u2010Risk Pregnancies: A Secondary Analysis of a Prospective Cohort Study"],"prefix":"10.1111","volume":"132","author":[{"given":"Mekayla","family":"Forrest","sequence":"first","affiliation":[{"name":"Vascular Health Unit Research Institute of McGill University Health Centre  Montreal Quebec Canada"},{"name":"Department of Medicine McGill University  Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Matossian","sequence":"additional","affiliation":[{"name":"Vascular Health Unit Research Institute of McGill University Health Centre  Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helena","family":"Papacostas Quintanilla","sequence":"additional","affiliation":[{"name":"Vascular Health Unit Research Institute of McGill University Health Centre  Montreal Quebec Canada"},{"name":"Department of Medicine McGill University  Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabelle","family":"Malham\u00e9","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Medicine McGill University Health Centre  Montreal Quebec Canada"},{"name":"Centre for Outcomes Research and Evaluation Research Institute of the McGill University Health Centre  Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tina","family":"Montreuil","sequence":"additional","affiliation":[{"name":"Department of Medicine McGill University  Montreal Quebec Canada"},{"name":"Department of Educational and Counselling Psychology, Faculty of Education McGill University  Montreal Quebec Canada"},{"name":"Psychiatry Department Research Institute of McGill University Health Centre  Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4774-2549","authenticated-orcid":false,"given":"Stella S.","family":"Daskalopoulou","sequence":"additional","affiliation":[{"name":"Vascular Health Unit Research Institute of McGill University Health Centre  Montreal Quebec Canada"},{"name":"Division of General Internal Medicine, Department of Medicine McGill University Health Centre  Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,8,8]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00737-013-0409-0"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6909.2009.01054.x"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2001.00122.x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00359-7"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.31887\/DCNS.2015.17.3\/bbandelow"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2011.03.006"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2020.10.058"},{"issue":"4","key":"e_1_2_10_9_1","first-page":"1181","article-title":"The Prevalence of Anxiety Disorders During Pregnancy and the Postpartum Period: A Multivariate Bayesian Meta\u2010Analysis","volume":"80","author":"Fawcett E. 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