Introduction Today, antenatal anomaly screening tests (AAST) are among routine pregnancy cares in most countries. According to the American College of Obstetrics and Gynecology guidelines, taking these tests is emphatically recommended to all pregnant mothers. In addition, the need to provide the conditions for informed choice is accentuated (1). An informed choice refers to an option for each person, which causes them more satisfaction and less anxiety about their decision. To make informed decisions, individuals may seek information about the experience of a particular health condition and how individuals cope with a negative experience (2). Approximately 5 out of every 100 pregnant women who undergo the first-trimester screening tests receive high- risk results. Almost 3 out of every 100 women, who acquire high-risk results and take diagnostic tests, expect children with Down syndrome (3). Hence, most women experience unreasonable anxiety in the process of performing such tests (4). Parents go through challenging times while anticipating test results since they are concerned about the unfavorable results (5). Individuals who receive high- risk results experience increased anxiety and stress as they must undergo diagnostic tests, which increases the risk of miscarriage (6). Health care providers do not appear to devote enough time to train pregnant women before screening tests and ultrasounds, leading to concern and reduced informed choice among parents (5,7-9). Although screening tests are ultimately advantageous in improving community health and reducing the costs of caring for children with chromosomal abnormalities, uncontrolled stress during this period might adversely affect the mother’s mental health. Studies indicate that women’s anxiety levels significantly increase after receiving a positive result in a screening test (10). In some mothers, the anxiety persists even after receiving a normal result to screening and/or diagnostic tests (11). Pregnancy anxiety can increase the incidence of postpartum depression (12), preterm labor, and low birth weight (13,14). Postpartum depression has a high prevalence (56.9%) in Iranian society (15), so interventions are needed to alleviate these concerns. Reducing anxiety at this critical stage of a woman’s life can influence the life quality and prenatal health. Abstract Objectives: Although antenatal anomaly screening tests (AAST) provide valuable information about fetal health, performed to prevent the birth of children with chromosomal abnormalities, uncontrolled stress while performing such tests may negatively affect the mother’s mental health. This study aimed to systematically review clinical trial studies in which reducing pregnant women’s anxiety and concern in the process of performing AAST was among their objectives. Materials and Methods: In this systematic review, six electronic databases (Scopus, Cochrane Library, Science Direct, PubMed, Google Scholar, and CINAHL) were searched. Data extraction was performed through randomized controlled trials (RCTs) in English, which the core fell onto designing an intervention to reduce pregnant women’s anxiety and concern associated with performing AAST. Results: Out of the 1946 studies, six were included in this systematic review. In most studies, a positive impact on knowledge and satisfaction with the information received was observed. However, no effect was reported regarding decreasing or increasing the anxiety and concern of pregnant women in the process of performing AAST. Studies were heterogeneous in terms of intervention type and gestational age of participants. Conclusions: Interventions aimed at providing pregnant women with specific information about prenatal screening for chromosomal abnormalities have no impact on reducing their anxiety and concern. Therefore, designing educational-psychological interventions to prevent and reduce anxiety and concern of pregnant women in this period is recommended. Keywords: Pregnant women, Antenatal screening, Anxiety, Systematic review Reducing the Anxiety and Concern of Pregnant Women during Antenatal Anomaly Screening Tests: A Systematic Review Zohreh Khakbazan 1 , Farnaz Farnam 1 , Sedigheh Hantoushzadeh 2 , Parsa Abdollahi 3 , Mitra Arjmandifar 1* Open Access Review Article International Journal of Women’s Health and Reproduction Sciences Vol. 10, No. 4, October 2022, 172–179 http://www.ijwhr.net doi 10.15296/ijwhr.2022.30 ISSN 2330- 4456 Received 14 April 2021, Accepted 10 October 2021, Available online 16 March 2022 1 Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran. 2 Maternal-Fetal Neonatal, Vali-e-Asr Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 3 School of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran. *Corresponding Author: Mitra Arjmandifar, Tel: (+98) 9122841970, Email: m-arjmandifar@alumnus.tums.ac.ir; arj7087@yahoo.com