Postpartum depression and anxiety: a community-based study on risk factors before, during and after pregnancy

Angarath I Van Der Zee-Van Den Berg,Magda M Boere-Boonekamp,Catharina G.M Groothuis-Oudshoorn,Sijmen A Reijneveld

doi:10.1016/j.jad.2021.02.062

Angarath I Van Der Zee-Van Den Berg, Magda M Boere-Boonekamp + Show 2 more

Open Access

https://doi.org/10.1016/j.jad.2021.02.062

Copy DOI

Abstract

BackgroundDepression and anxiety occur frequently postpartum, calling for early detection and treatment. Evidence on risk factors may support early detection, but is inconclusive. Our aim was to identify risk factors for postpartum depression and anxiety, before, during and after pregnancy. MethodsWe used data from 1406 mothers of the intervention arm of the Post-Up study. Risk factors were collected at 3 weeks and 12 months postpartum. Depression and anxiety symptoms were measured in the first month postpartum by the Edinburgh Postnatal Depression Scale (EPDS) and 6-item State-Trait Anxiety Inventory (STAI-6), respectively. We used stepwise logistic regression to identify relevant risk factors. ResultsOf the mothers, 8.0% had EPDS-scores ≥9 and 14.7% STAI-6-scores ≥42. Factors associated with higher risk of depression were: foreign language spoken at home, history of depression, low maternal self-efficacy and poor current health of the mother. No initiation of breastfeeding was associated with lower risk of depression, no breastfeeding at 3 weeks postpartum increased the risk. Factors associated with higher risk of anxiety were: higher educational level, history of depression, preterm birth, negative experience of delivery and first week postpartum, excessive infant crying, low maternal self-efficacy, low partner support and poor current maternal health. LimitationsUse of a self-report instrument, potential bias by postpartum mood status, and no inclusion of emerging depression cases after one month postpartum. ConclusionsThe shared and separate risk factors for postpartum depression and anxiety may help professionals in identifying mothers at increased risk and provide opportunities for preventive interventions and treatment.

Highlights

Maternal mental well-being during the postpartum period is of major importance both for the mother and for a healthy development of the newborn
Multivariable analyses (Table 2) indicated several factors that were associated with a higher risk: foreign language spoken at home, lifetime history of depression, low score on the Self-Efficacy in the nurturing role questionnaire (SENR), and poor current health of the mother
Factors associated with higher risk in the multivariable analyses were lower education, lifetime history of depression, preterm birth, delivery experienced negatively, first week postpartum experi enced negatively, crying experienced as excessive, low score on SENR, low support of partner, and poor current health of mother

Summary

Introduction

Maternal mental well-being during the postpartum period is of major importance both for the mother and for a healthy development of the newborn. Factors associated with higher risk of depression were: foreign language spoken at home, history of depression, low maternal self-efficacy and poor current health of the mother. Factors associated with higher risk of anxiety were: higher educational level, history of depression, preterm birth, negative experience of delivery and first week postpartum, excessive infant crying, low maternal self-efficacy, low partner support and poor current maternal health. Conclusions: The shared and separate risk factors for postpartum depression and anxiety may help professionals in identifying mothers at increased risk and provide opportunities for preventive interventions and treatment

Objectives

Methods

Results

Discussion

Conclusion