{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T06:58:25Z","timestamp":1785308305121,"version":"3.55.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Psychological well-being in early pregnancy may differ by maternal age and by sociodemographic, economic, and reproductive circumstances. This study examined the associations of maternal age and other participant characteristics with screen-positive anxiety symptoms, screen-positive depressive symptoms, perceived stress, and composite psychological distress during the first trimester.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 1,282 women attending routine antenatal care at 10\u201312\u202fweeks of gestation were included. Participants were classified into three maternal age categories: 18\u201329, 30\u201334, and \u226535\u202fyears. Psychological symptoms were assessed using the Edinburgh Postnatal Depression Scale, the Perceived Stress Scale, and the State\u2013Trait Anxiety Inventory. Composite psychological distress was defined as meeting the prespecified threshold for screen-positive anxiety symptoms, screen-positive depressive symptoms, or high perceived stress. Associations were examined using multivariable logistic and linear regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean state anxiety, trait anxiety, Edinburgh Postnatal Depression Scale, and perceived stress scores increased across maternal age categories. Screen-positive anxiety symptoms were present in 15.9, 23.2, and 33.0% of women aged 18\u201329, 30\u201334, and \u226535\u202fyears, respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001); the corresponding prevalence of composite psychological distress was 28.9, 35.2, and 47.4% (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). After adjustment, each one-category increase in maternal age was associated with higher odds of composite psychological distress (adjusted odds ratio [aOR]\u202f=\u202f1.58, 95% CI 1.35\u20131.84;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) and screen-positive anxiety symptoms (aOR\u202f=\u202f1.76, 95% CI 1.48\u20132.10;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), as well as a 0.20-point increase in perceived stress score (95% CI 0.11\u20130.29;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Conception through assisted reproductive technology and perceived financial strain were associated with higher odds of both binary outcomes. Perceived financial strain and work and career pressure were associated with higher perceived stress scores, whereas being currently married was associated with a lower score.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Maternal age, conception through assisted reproductive technology, perceived financial strain, work and career pressure, and marital status were associated with psychological outcomes in early pregnancy. Prospective studies are needed to confirm these findings and identify feasible screening and support strategies for routine antenatal care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyg.2026.1818113","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T05:58:27Z","timestamp":1785304707000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Maternal age and psychological well-being in early pregnancy: a cross-sectional analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Juan","family":"Ran","sequence":"first","affiliation":[{"name":"Chengdu Wenjiang Maternal and Child Health Hospital","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huanhuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Chengdu Wenjiang Maternal and Child Health Hospital","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoping","family":"Chen","sequence":"additional","affiliation":[{"name":"Chengdu Wenjiang Maternal and Child Health Hospital","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"62","DOI":"10.3109\/0167482X.2012.673040","article-title":"A review and psychometric evaluation of pregnancy-specific stress measures","volume":"33","author":"Alderdice","year":"2012","journal-title":"J. Psychosom. Obstet. Gynaecol."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1232","DOI":"10.1097\/AOG.0000000000005200","article-title":"Screening and diagnosis of mental health conditions during pregnancy and postpartum: ACOG clinical practice guideline no. 4","volume":"141","year":"","journal-title":"Obstet. Gynecol."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1262","DOI":"10.1097\/AOG.0000000000005202","article-title":"Treatment and management of mental health conditions during pregnancy and postpartum: ACOG clinical practice guideline no. 5","volume":"141","year":"","journal-title":"Obstet. Gynecol."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1186\/1471-2393-12-100","article-title":"Advanced maternal age and risk perception: a qualitative study","volume":"12","author":"Bayrampour","year":"2012","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1016\/j.jad.2015.11.014","article-title":"Identifying the women at risk of antenatal anxiety and depression: a systematic review","volume":"191","author":"Biaggi","year":"2016","journal-title":"J. Affect. Disord."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1016\/j.midw.2010.07.006","article-title":"Advanced maternal age and adverse perinatal outcome: a review of the evidence","volume":"27","author":"Carolan","year":"2011","journal-title":"Midwifery"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"385","DOI":"10.2307\/2136404","article-title":"A global measure of perceived stress","volume":"24","author":"Cohen","year":"1983","journal-title":"J. Health Soc. Behav."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"782","DOI":"10.1192\/bjp.150.6.782","article-title":"Detection of postnatal depression: development of the 10-item Edinburgh postnatal depression scale","volume":"150","author":"Cox","year":"1987","journal-title":"Br. J. Psychiatry"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1001\/jama.2019.0007","article-title":"Interventions to prevent perinatal depression: US preventive services task force recommendation statement","volume":"321","author":"Curry","year":"2019","journal-title":"JAMA"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1192\/bjp.bp.116.187179","article-title":"Prevalence of antenatal and postnatal anxiety: systematic review and meta-analysis","volume":"210","author":"Dennis","year":"2017","journal-title":"Br. J. Psychiatry"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"2041","DOI":"10.1017\/S0033291717000617","article-title":"The prevalence of antenatal and postnatal co-morbid anxiety and depression: a meta-analysis","volume":"47","author":"Falah-Hassani","year":"2017","journal-title":"Psychol. Med."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"18r12527","DOI":"10.4088\/JCP.18r12527","article-title":"The prevalence of anxiety disorders during pregnancy and the postpartum period: a multivariate Bayesian meta-analysis","volume":"80","author":"Fawcett","year":"2019","journal-title":"J. Clin. Psychiatry"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"139G","DOI":"10.2471\/BLT.11.091850","article-title":"Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review","volume":"90","author":"Fisher","year":"2012","journal-title":"Bull. World Health Organ."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"e321","DOI":"10.4088\/JCP.12r07968","article-title":"The impact of maternal depression during pregnancy on perinatal outcomes: a systematic review and meta-analysis","volume":"74","author":"Grigoriadis","year":"2013","journal-title":"J. Clin. Psychiatry"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1012","DOI":"10.1001\/archgenpsychiatry.2010.111","article-title":"A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction","volume":"67","author":"Grote","year":"2010","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1093\/humupd\/dmn030","article-title":"Psychological and social aspects of pregnancy, childbirth and early parenting after assisted conception: a systematic review","volume":"14","author":"Hammarberg","year":"2008","journal-title":"Hum. Reprod. Update"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1775","DOI":"10.1016\/S0140-6736(14)61276-9","article-title":"Non-psychotic mental disorders in the perinatal period","volume":"384","author":"Howard","year":"2014","journal-title":"Lancet"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"S467","DOI":"10.1002\/acr.20561","article-title":"Measures of anxiety: state-trait anxiety inventory, Beck anxiety inventory, and hospital anxiety and depression scale-anxiety","volume":"63","author":"Julian","year":"2011","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1016\/j.ajog.2009.09.007","article-title":"Risk factors for depressive symptoms during pregnancy: a systematic review","volume":"202","author":"Lancaster","year":"2010","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1111\/1471-0528.12659","article-title":"Advanced maternal age and pregnancy outcomes: a multicountry assessment","volume":"121","author":"Laopaiboon","year":"2014","journal-title":"BJOG"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"e0186287","DOI":"10.1371\/journal.pone.0186287","article-title":"Advanced maternal age and adverse pregnancy outcomes: a systematic review and meta-analysis","volume":"12","author":"Lean","year":"2017","journal-title":"PLoS One"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1192\/bjp.172.5.433","article-title":"Detecting postnatal depression in Chinese women: validation of the Chinese version of the Edinburgh postnatal depression scale","volume":"172","author":"Lee","year":"1998","journal-title":"Br. J. Psychiatry"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1080\/02646839008403615","article-title":"Screening for depression during pregnancy with the Edinburgh depression scale (EPDS)","volume":"8","author":"Murray","year":"1990","journal-title":"J. Reprod. Infant Psychol."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1001\/jama.2015.18948","article-title":"Primary care screening for and treatment of depression in pregnant and postpartum women: evidence report and systematic review for the US preventive services task force","volume":"315","author":"O'Connor","year":"2016","journal-title":"JAMA"},{"key":"ref25","volume-title":"Manual for the State-Trait Anxiety Inventory (Form Y)","author":"Spielberger","year":"1983"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1800","DOI":"10.1016\/S0140-6736(14)61277-0","article-title":"Effects of perinatal mental disorders on the fetus and child","volume":"384","author":"Stein","year":"2014","journal-title":"Lancet"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1093\/humupd\/dml040","article-title":"Women's emotional adjustment to IVF: a systematic review of 25 years of research","volume":"13","author":"Verhaak","year":"2007","journal-title":"Hum. Reprod. Update"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1177\/07067437241303031","article-title":"Canadian network for mood and anxiety treatments 2024 clinical practice guideline for the management of perinatal mood, anxiety, and related disorders","volume":"70","author":"Vigod","year":"2025","journal-title":"Can. J. Psychiatr."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"e296","DOI":"10.1371\/journal.pmed.0040296","article-title":"The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"4","author":"von Elm","year":"2007","journal-title":"PLoS Med."},{"key":"ref30","doi-asserted-by":"publisher","first-page":"101932","DOI":"10.1016\/j.cpr.2020.101932","article-title":"Prevalence and associated factors of antenatal depression: systematic reviews and meta-analyses","volume":"83","author":"Yin","year":"2021","journal-title":"Clin. Psychol. 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