Pregnancy-Related Anxiety Questionnaire—Revised 2
Pregnancy-Related Anxiety Questionnaire-Revised 2 (PRAQ-R2) · Also known as: PRAQ-R2, PRAQ
The Pregnancy-Related Anxiety Questionnaire—Revised 2 (PRAQ-R2) is a 10-item self-report measure designed specifically to assess anxiety unique to pregnancy, focusing on two core pregnancy-related concerns: fear of bearing a handicapped child and worries about changes to one's own body and appearance. Developed and refined by Huizink and colleagues, the PRAQ-R2 is based on the observation that pregnancy-related anxiety reflects distinct cognitive and emotional preoccupations that differ from generalized anxiety disorders.
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When to use it
The PRAQ-R2 is most valuable in research contexts examining pregnancy-related anxiety as a distinct construct, particularly in longitudinal studies of prenatal stress and fetal development or in trials evaluating psychosocial interventions. In clinical settings, it is useful when a clinician aims to measure pregnancy-specific anxiety concerns separately from general anxiety symptoms, allowing targeted discussion and intervention. The scale is appropriate for antenatal visits and can be readministered at different pregnancy trimesters to track anxiety trajectories. It is particularly relevant in high-risk obstetric populations (e.g., history of fetal loss, infertility treatment) where pregnancy-related fears are heightened.
Strengths & limitations
- Targets pregnancy-specific anxiety dimensions that are distinct from generalized anxiety, improving measurement precision.
- Brief and efficient (3-5 minutes), facilitating integration into antenatal research studies and busy clinical environments.
- Subscale structure (fear of fetal abnormality vs. body changes) provides clinically meaningful differentiation of anxiety domains.
- Extensively used in international perinatal research with translations in multiple languages; robust normative data available.
- Items are clearly written and intuitive, reducing burden on pregnant participants.
- Not designed as a diagnostic tool; elevated scores require clinical confirmation and should not be interpreted as a diagnosis of an anxiety disorder.
- Subscales are brief (5 items each), which may limit reliability in some populations; internal consistency (Cronbach's α) is moderate (0.65-0.75).
- Primarily validated in high-income countries and predominantly among white, educated pregnant women; cultural validity in diverse populations is less established.
- Does not assess obsessive-compulsive anxiety, posttraumatic stress, or panic symptoms, which may co-occur with pregnancy-related anxiety.
Frequently asked
Can the PRAQ-R2 be used postpartum or in non-pregnant women?
The PRAQ-R2 is specifically designed for pregnant women and item wording assumes current pregnancy. It is not validated for postpartum or non-pregnant populations. For postpartum women, the Perinatal Anxiety Screening Scale or postpartum-specific anxiety measures are more appropriate.
What is a clinical cutoff score for the PRAQ-R2?
There is no universally agreed diagnostic cutoff; rather, PRAQ-R2 is interpreted dimensionally. Research suggests scores ≥35 indicate elevated pregnancy-related anxiety. However, for clinical decisions, the score should be contextualized with clinical interview, symptom duration, and functional impairment rather than relied upon alone.
How does the PRAQ-R2 differ from the PASS?
The PRAQ-R2 (10 items) targets pregnancy-specific worries about fetal health and body changes, while the PASS (31 items) is a broader perinatal anxiety screening tool capturing generalized anxiety, panic, and obsessive-compulsive symptoms in both pregnancy and postpartum. The PRAQ-R2 is narrower and more specific to pregnancy; the PASS is broader but also suitable for postpartum screening.
Are there validated translations of the PRAQ-R2?
Yes, the PRAQ-R2 has been translated into multiple languages including Dutch, German, French, Swedish, and others. Published validation studies exist for several translations. Users should employ published translations rather than producing new translations to ensure psychometric equivalence.
Sources
- Huizink, A. C., Mulder, E. J., & Buitelaar, J. K. (2004). Prenatal stress and risk for psychopathology: specific effects or inert vulnerability? Psychological Bulletin, 130(1), 115-142. link ↗
- Huizink, A. C., Robles de Medina, P. G., Mulder, E. J., Visser, G. H., & Buitelaar, J. K. (2016). Is pregnancy anxiety a distinctive syndrome? Early Human Development, 79(2), 81-91. link ↗
How to cite this page
ScholarGate. (2026, June 3). Pregnancy-Related Anxiety Questionnaire-Revised 2 (PRAQ-R2). ScholarGate. https://scholargate.app/en/obstetrics-gynecology/pregnancy-related-anxiety-questionnaire
Which method?
Set this method beside its closest kin and read them side by side — the library lays the books on the table; the choice is yours.
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