Cross-cultural adaptation and validation of the Turkish version of the Pregnancy-Specific Anxiety Tool (PSAT-TR): a psychometric study

Background: Pregnancy-specific anxiety (PSA) is a distinct form of anxiety that affects maternal well-being and pregnancy outcomes. Reliable and culturally appropriate instruments are essential for its accurate assessment. This study aimed to adapt and validate the Turkish version of the Pregnancy-Specific Anxiety Tool (PSAT-TR) and to evaluate its psychometric properties among pregnant women in Türkiye. Methods: This methodological study included 300 pregnant women attending antenatal clinics at Gaziosmanpaşa Training and Research Hospital between September and October 2025. The original PSAT was translated into Turkish through forward–backward translation and expert evaluation in accordance with COSMIN guidelines. Construct validity was assessed using exploratory and confirmatory factor analyses (EFA and CFA). Internal consistency was evaluated with Cronbach’s alpha and McDonald’s omega coefficients, and test–retest reliability with intraclass correlation coefficients (ICC). Concurrent validity was examined through correlations between PSAT-TR scores and those of the State–Trait Anxiety Inventory (STAI) and the Pregnancy-Related Anxiety Questionnaire–Revised 2 (PRAQ-R2). Results: EFA supported a six-factor structure explaining 59.0% of the total variance. CFA confirmed an excellent model fit (χ²/df = 2.81, CFI = 0.995, TLI = 0.994, RMSEA = 0.025). The PSAT-TR demonstrated excellent internal consistency (Cronbach’s α = 0.945, ω = 0.950) and strong test–retest reliability (ICC = 0.909–0.979). Significant positive correlations were found between PSAT-TR and STAI-State (r = 0.428, p < 0.001) and PRAQ-R2 (r = 0.569, p < 0.001) scores, confirming concurrent validity. Conclusions: The Turkish version of the Pregnancy-Specific Anxiety Tool (PSAT-TR) is a valid and reliable measure for assessing pregnancy-specific anxiety among Turkish women. Its use in both clinical and research settings may facilitate the early detection and management of pregnancy-related anxiety. Trial registration: Not applicable