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Zhao T, Jhangri GS, Dobson KS, Li JY, Premji SS, Tao F, Zhu B, Yamamoto SS. The impact of prenatal mental health on birth outcomes before and during the COVID-19 pandemic in Anhui, China. PLoS One 2024; 19:e0308327. [PMID: 39106266 DOI: 10.1371/journal.pone.0308327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 07/22/2024] [Indexed: 08/09/2024] Open
Abstract
Adverse birth outcomes remain challenging public health problems in China. Increasing evidence indicated that prenatal depression and anxiety are associated with adverse birth outcomes, highlighting the importance and severity of prenatal depression and anxiety in China. The COVID-19 pandemic is likely to further exacerbate prenatal mental health problems and increase the risk of adverse birth outcomes. The aim of this study is to assess and compare the impacts of prenatal mental health issues on birth outcomes before and during the COVID-19 pandemic in Ma'anshan, Anhui, China. Participants in this study were women who visited local maternal and child health hospitals in Ma'anshan, Anhui, China. Two independent sets of individual maternal data (npre-pamdemic = 1148; npandemic = 2249) were collected. Prenatal depression and anxiety were measured online using the Edinburgh Postnatal Depression Scale (EPDS) and the General Anxiety Disorder-7 (GAD-7). Adverse birth outcomes were determined using hospital-recorded infant birth weight and gestational age at delivery. In this study, we found that the pandemic cohort had lower mean EPDS and GAD-7 scores than the pre-pandemic cohort. The prevalence of prenatal depression (14.5%) and anxiety (26.7%) among the pandemic cohort were lower than the pre-pandemic cohort (18.6% and 36.3%). No significant difference was found in the prevalence of adverse birth outcomes comparing the two cohorts. Prenatal depression was associated with small gestational age only in the pandemic cohort (OR = 1.09, 95% CI 1.00-1.19, p = 0.042). Overall, this study highlighted an association between prenatal depression and small for gestational age in Anhui, China. Addressing prenatal depression may thus be key in improving birth outcomes. Future studies could focus on potential causal relationships.
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Affiliation(s)
- Tianqi Zhao
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Gian S Jhangri
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Keith S Dobson
- Faculty of Arts, Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Jessica Yijia Li
- Faculty of Social Sciences, Department of Psychology, University of Victoria, Victoria, BC, Canada
| | - Shahirose S Premji
- Faculty of Health Sciences, School of Nursing, Queen's University, Kingston, Ontario, Canada
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Beibei Zhu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Shelby S Yamamoto
- School of Public Health, University of Alberta, Edmonton, AB, Canada
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Meades R, Sinesi A, Williams LR, Delicate A, Cheyne H, Maxwell M, Alderdice F, Jomeen J, Shakespeare J, Yuill C, Ayers S. Evaluation of perinatal anxiety assessment measures: a cognitive interview study. BMC Pregnancy Childbirth 2024; 24:507. [PMID: 39068407 PMCID: PMC11283684 DOI: 10.1186/s12884-024-06641-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 06/14/2024] [Indexed: 07/30/2024] Open
Abstract
BACKGROUND Anxiety in pregnancy and postpartum is highly prevalent but under-recognised. To identify perinatal anxiety, assessment tools must be acceptable, relevant, and easy to use for women in the perinatal period. METHODS To determine the acceptability and ease of use of anxiety measures to pregnant or postpartum women (n = 41) we examined five versions of four measures: the Generalised Anxiety Disorder scale (GAD) 2-item and 7-item versions; Whooley questions; Clinical Outcomes in Routine Evaluation (CORE-10); and Stirling Antenatal Anxiety Scale (SAAS). Cognitive interviews were used to examine ease of comprehension, judgement, retrieval and responding. RESULTS All measures were acceptable. Some items were deemed less relevant to the perinatal period e.g., difficulties sleeping. Ease of comprehension, judgement, retrieval and responding varied, with all measures having strengths and weaknesses. The SAAS and CORE-10 had the lowest mean number of problematic components. The GAD had the highest mean number of problematic components. Non-binary response options were preferred. Preferences for time frames (e.g. one week, one month) varied. Qualitative data provides in-depth information on responses to each measure. CONCLUSIONS Findings can be used to inform clinical guidelines and research on acceptable anxiety assessment in pregnancy and after birth.
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Affiliation(s)
- Rose Meades
- Centre for Maternal and Child Health Research, School of Health and Psychological Sciences, City, University of London, Northampton Square, London, EC1V 0HB, UK.
| | | | - Louise R Williams
- Centre for Maternal and Child Health Research, School of Health and Psychological Sciences, City, University of London, Northampton Square, London, EC1V 0HB, UK
| | | | - Helen Cheyne
- Centre for Maternal and Child Health Research, School of Health and Psychological Sciences, City, University of London, Northampton Square, London, EC1V 0HB, UK
- Nursing, Midwifery and Allied Health Professions Research Unit, Pathfoot Building, University of Stirling, Stirling, FK9 4LA, UK
| | - Margaret Maxwell
- Nursing, Midwifery and Allied Health Professions Research Unit, Pathfoot Building, University of Stirling, Stirling, FK9 4LA, UK
| | - Fiona Alderdice
- Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
| | - Julie Jomeen
- Southern Cross University, Gold Coast Airport, Terminal Dr, QLD 4225, Bilinga, Australia
| | - Judy Shakespeare
- Independent Researcher - Retired General Practitioner, Oxford, UK
| | - Cassandra Yuill
- Centre for Maternal and Child Health Research, School of Health and Psychological Sciences, City, University of London, Northampton Square, London, EC1V 0HB, UK
| | - Susan Ayers
- Centre for Maternal and Child Health Research, School of Health and Psychological Sciences, City, University of London, Northampton Square, London, EC1V 0HB, UK
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Song Z, Zhang D, Yang L, Zhu P, Liu Y, Wang S, Zheng R. Factor structure and longitudinal invariance for the Chinese Mainland version of the Edinburgh postnatal depression scale during pregnancy. Midwifery 2024; 132:103963. [PMID: 38457994 DOI: 10.1016/j.midw.2024.103963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 02/21/2024] [Accepted: 02/27/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND There are inconsistent results on the Edinburgh Postnatal Depression Scale's (EPDS) factor structure and longitudinal invariance among different cultures. Furthermore, limited relevant studies in Chinese pregnant women exist. PURPOSE To test the factor structure of the Chinese Mainland EPDS during pregnancy and conduct longitudinal invariance analyses. METHODS A national multi-centre cohort study was conducted among 1207 pregnant women selected consecutively by convenience sampling from five hospitals in Zhuhai, Taiyuan, Haidian, Changchun, and Shenzhen in China between August 2015 and October 2016. Depression was measured by the EPDS during gestational weeks 10-13, 15-18, 23-25, 30-32 and 36-37, respectively.s RESULTS: Three factors with eigenvalues nearly larger than 1.0 were optimal for the Chinese Mainland EPDS, labelled "anxiety," "anhedonia," and "depression," and contained items 3-5, 1-2, and 6-10, respectively. The confirmatory factor analysis results of standardized root mean square residual (SRMR) = 0.034, root mean square error of approximation (RMSEA) = 0.049, comparative fit index (CFI) = 0.968, Tucker-Lewis index (TLI) = 0.954, and χ2, p < 0.05 indicated good fit. For the longitudinal invariance tests, the configural invariance was met, with the CFI and TLI both higher than 0.90 and the RMSEA lower than 0.08 (CFI = 0.919, TLI = 0.908, and RMSEA = 0.034). The metric-, scalar-, and strict invariances were met. CONCLUSIONS The three-factor model of the Chinese Mainland EPDS is invariant in pregnancy, suggesting stability and comparability in identifying the women screened positive at different points during pregnancy and making the scale feasible to screen prenatal depression and anxiety simultaneously.
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Affiliation(s)
- Zhijiao Song
- Department of Epidemiology, Center of Clinical Epidemiology and Evidence Based Medicine, School of Public Health, Shanxi Medical University, 56 Xinjian South Road, Taiyuan, Shanxi 030001, China; Department of Health Education, Shanxi Women and Children Health Hospital, Taiyuan 030013, China
| | - Daming Zhang
- Department of Child and Adolescent, School of Public health, Shanxi Medical University, Taiyuan 030001, China; Department of Mental Health, Shanxi Women and Children Health Hospital, Taiyuan 030013, China
| | - Li Yang
- Department of Women's Health, National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, No.12 Dahui Road, Haidian District, Beijing 100081, China
| | - Pengfei Zhu
- Center of Reproductive Medicine, Shanxi Women and Children Health Hospital, Taiyuan, 030013, China
| | - Yan Liu
- Cancer prevention and control office, Shanxi Province Cancer Hospital/ Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan 030013, China
| | - Suping Wang
- Department of Epidemiology, Center of Clinical Epidemiology and Evidence Based Medicine, School of Public Health, Shanxi Medical University, 56 Xinjian South Road, Taiyuan, Shanxi 030001, China.
| | - Ruimin Zheng
- Department of Women's Health, National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, No.12 Dahui Road, Haidian District, Beijing 100081, China.
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Koerner R, Rechenberg K, Rinaldi K, Duffy A. Are Providers Adequately Screening for Anxiety Symptoms During Pregnancy? Nurs Womens Health 2024; 28:109-116. [PMID: 38278513 DOI: 10.1016/j.nwh.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 09/19/2023] [Accepted: 12/06/2023] [Indexed: 01/28/2024]
Abstract
OBJECTIVE To examine the difference in prevalence of self-reported anxiety symptoms throughout pregnancy compared to clinical diagnosis of an anxiety disorder by a provider. DESIGN Secondary data analysis of a prospective cohort study of 50 pregnant individuals. SETTING/LOCAL PROBLEM Pregnant individuals commonly experience heightened anxiety symptoms, which are associated with adverse perinatal outcomes. However, a diagnosis of an anxiety disorder by a health care provider is less common, which may result in insufficient mental health intervention. PARTICIPANTS Pregnant individuals were recruited at their first prenatal appointment and followed until birth. INTERVENTION/MEASUREMENTS We examined anxiety symptoms using the Edinburgh Postnatal Depression Scale Anxiety subscale. We conducted a medical record review to examine if pregnant individuals were clinically diagnosed with an anxiety disorder. RESULTS Based on an Edinburgh Postnatal Depression Scale Anxiety subscale cutoff score of ≥5, 40% (n = 20) of individuals experienced anxiety symptoms during pregnancy. However, only 16% (n = 8) of participants were diagnosed with an anxiety disorder by a health care provider. CONCLUSION Anxiety symptoms are prevalent throughout pregnancy and may be underdiagnosed by health care providers. An intervention to increase clinical diagnosis of an anxiety disorder and subsequent referral to a mental health specialist may be indicated.
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Ayers S, Sinesi A, Coates R, Cheyne H, Maxwell M, Best C, McNicol S, Williams LR, Uddin N, Shakespeare J, Alderdice F. When is the best time to screen for perinatal anxiety? A longitudinal cohort study. J Anxiety Disord 2024; 103:102841. [PMID: 38367480 DOI: 10.1016/j.janxdis.2024.102841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 01/02/2024] [Accepted: 01/29/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND For screening for anxiety during pregnancy and after birth to be efficient and effective it is important to know the optimal time to screen in order to identify women who might benefit from treatment. AIMS To determine the optimal time to screen for perinatal anxiety to identify women with anxiety disorders and those who want treatment. A secondary aim was to examine the stability and course of perinatal anxiety over time. METHODS Prospective longitudinal cohort study of 2243 women who completed five screening questionnaires of anxiety and mental health symptoms in early pregnancy (11 weeks), mid-pregnancy (23 weeks), late pregnancy (32 weeks) and postnatally (8 weeks). Anxiety and mental health questionnaires were the GAD7, GAD2, SAAS, CORE-10 and Whooley questions. To establish presence of anxiety disorders diagnostic interviews were conducted with a subsample of 403 participants. RESULTS Early pregnancy was the optimal time to screen for anxiety to identify women with anxiety disorders and women wanting treatment at any time during pregnancy or postnatally. These findings were consistent across all five questionnaires of anxiety and mental health. Receiving treatment for perinatal mental health problems was most strongly associated with late pregnancy and/or postnatal assessments. Anxiety symptoms were highest in early pregnancy and decreased over time. CONCLUSION Findings show that screening in early pregnancy is optimal for identifying women who have, or develop, anxiety disorders and who want treatment. This has clear implications for practice and policy for anxiety screening during the perinatal period.
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Affiliation(s)
- Susan Ayers
- Centre for Maternal and Child Health Research, School of Health and Psychological Sciences, City, University of London, Northampton Square, London, UK.
| | - Andrea Sinesi
- Nursing, Midwifery and Allied Health Professions Research Unit, Pathfoot Building, University of Stirling, Stirling, UK
| | - Rose Coates
- Centre for Maternal and Child Health Research, School of Health and Psychological Sciences, City, University of London, Northampton Square, London, UK
| | - Helen Cheyne
- Nursing, Midwifery and Allied Health Professions Research Unit, Pathfoot Building, University of Stirling, Stirling, UK
| | - Margaret Maxwell
- Nursing, Midwifery and Allied Health Professions Research Unit, Pathfoot Building, University of Stirling, Stirling, UK
| | - Catherine Best
- Nursing, Midwifery and Allied Health Professions Research Unit, Pathfoot Building, University of Stirling, Stirling, UK
| | - Stacey McNicol
- Nursing, Midwifery and Allied Health Professions Research Unit, Pathfoot Building, University of Stirling, Stirling, UK
| | - Louise R Williams
- Centre for Maternal and Child Health Research, School of Health and Psychological Sciences, City, University of London, Northampton Square, London, UK
| | - Nazihah Uddin
- Centre for Maternal and Child Health Research, School of Health and Psychological Sciences, City, University of London, Northampton Square, London, UK
| | | | - Fiona Alderdice
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, UK
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Fairbrother N, Stagg B, Scoten O, Keeney C, Cargnelli C. Perinatal anxiety disorders screening study: a study protocol. BMC Psychiatry 2024; 24:162. [PMID: 38395837 PMCID: PMC10893673 DOI: 10.1186/s12888-024-05575-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 01/31/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The anxiety and their related disorders (AD) are the most common of all mental health conditions, and affect approximately 20% of pregnant and postpartum people. They are associated with significant distress and life interference for sufferers, as well as negative consequences for fetal and infant development. At present, little if any routine screening for prenatal AD is being conducted and data regarding the most effective tools to screen for these disorders is lacking. The majority of screening studies suffer from methodological difficulties which undermine the confidence needed to recommend measures for population distribution. The primary purpose of this research is to identify the most accurate self-report tool(s) to screen for perinatal AD. METHODS A large, prospective cohort of pregnant people (N = 1,000) is being recruited proportionally across health service delivery regions in British Columbia (BC). The screening accuracy of a broad range of perinatal AD self-report measures are being assessed using gold standard methodology. Consenting individuals are administered online questionnaires followed by a semi-structured diagnostic interview between 16- and 36-weeks' gestation, and again between 6 and 20 weeks postpartum. Questionnaires include all screening measures, measures of sleep and unpaid family work, and questions pertaining to demographic and reproductive history, COVID-19, gender role burden, and mental health treatment utilization. Interviews assess all current anxiety disorders, as well as obsessive-compulsive disorder, and posttraumatic stress disorder. DISCUSSION This research is in response to an urgent demand for accurate perinatal AD screening tools based on high quality evidence. AD among perinatal people often go unidentified and untreated, resulting in continued suffering and life impairment. Findings from this research will inform healthcare providers, policymakers, and scientists, about the most effective approach to screening for anxiety and related disorders in pregnancy in the postpartum period.
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Affiliation(s)
- Nichole Fairbrother
- Department of Family Practice, University of British Columbia, Vancouver, Canada.
| | - Bryn Stagg
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada
| | - Olivia Scoten
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Cora Keeney
- Department of Family Practice, University of British Columbia, Vancouver, Canada
| | - Claudia Cargnelli
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada
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Chrzan-Dętkoś M, Murawska N, Łockiewicz M, de la Fe Rodriguez Muñoz M. Self-harm thoughts among postpartum women - associated factors. J Reprod Infant Psychol 2024:1-14. [PMID: 38319751 DOI: 10.1080/02646838.2024.2313487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 01/29/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND Even though in many countries suicide is the leading cause of maternal deaths during the postpartum period, the prevalence of thoughts of self-harm (SHTs), an important risk factor for suicide attempts, is still not well documented. AIM We aimed to investigate the prevalence of SHTs in a Polish cohort of postpartum women and identify socio-demographic and maternal mental health factors associated with experiencing SHTs. METHOD 1545 women took part in a midwife-led postpartum depression (PPD) screening. 337 of them reported SHTs. The Edinburgh Postpartum Depression Scale (EPDS) was administered. Specifically, we used an abbreviated 5-item version to assess depression symptoms, item 10 to assess SHTs, a composite score of items 1 and 2 - anhedonia, and a composite score of items 3, 4, and 5 - anxiety. Logistic regression analyses were performed to examine associations between variables. RESULTS Approximately 2% (n = 337) of women self-reported experiencingSHTs. Within the group of postpartum mothers who self-reported SHTs, 65.60% (n = 221) manifested the symptoms of PPD, and 56.40% (n = 190) - of anxiety. The symptoms of PPD, a mood disorder diagnosed in the past, and younger age were predictors of SHTs. CONCLUSION The results of this study can contribute to the development of prevention strategies: analysing separately items from PPD screening questionnaires focusing on SHTs can be an important part of prevention. The lack of the symptoms of PPD and anxiety risk does notexclude experiencing SHTs.
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Affiliation(s)
| | - Natalia Murawska
- Institute of Psychology, the University of Gdansk, Gdansk, Poland
| | - Marta Łockiewicz
- Institute of Psychology, the University of Gdansk, Gdansk, Poland
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O'Connor EA, Henninger ML, Perdue LA, Coppola EL, Thomas RG, Gaynes BN. Anxiety Screening: Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 2023; 329:2171-2184. [PMID: 37338868 DOI: 10.1001/jama.2023.6369] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Importance Anxiety is commonly seen in primary care and associated with substantial burden. Objective To review the benefits and harms of screening and treatment for anxiety and the accuracy of instruments to detect anxiety among primary care patients. Data Sources MEDLINE, PsychINFO, Cochrane library through September 7, 2022; references of existing reviews; ongoing surveillance for relevant literature through November 25, 2022. Study Selection English-language original studies and systematic reviews of screening or treatment compared with control conditions and test accuracy studies of a priori-selected screening instruments were included. Two investigators independently reviewed abstracts and full-text articles for inclusion. Two investigators independently rated study quality. Data Extraction and Synthesis One investigator abstracted data; a second checked accuracy. Meta-analysis results were included from existing systematic reviews where available; meta-analyses were conducted on original research when evidence was sufficient. Main Outcomes and Measures Anxiety and depression outcomes; global quality of life and functioning; sensitivity and specificity of screening tools. Results Of the 59 publications included, 40 were original studies (N = 275 489) and 19 were systematic reviews (including ≈483 studies [N≈81 507]). Two screening studies found no benefit for screening for anxiety. Among test accuracy studies, only the Generalized Anxiety Disorder (GAD) GAD-2 and GAD-7 screening instruments were evaluated by more than 1 study. Both screening instruments had adequate accuracy for detecting generalized anxiety disorder (eg, across 3 studies the GAD-7 at a cutoff of 10 had a pooled sensitivity of 0.79 [95% CI, 0.69 to 0.94] and specificity of 0.89 [95% CI, 0.83 to 0.94]). Evidence was limited for other instruments and other anxiety disorders. A large body of evidence supported the benefit of treatment for anxiety. For example, psychological interventions were associated with a small pooled standardized mean difference of -0.41 in anxiety symptom severity in primary care patients with anxiety (95% CI, -0.58 to -0.23]; 10 RCTs [n = 2075]; I2 = 40.2%); larger effects were found in general adult populations. Conclusions and Relevance Evidence was insufficient to draw conclusions about the benefits or harms of anxiety screening programs. However, clear evidence exists that treatment for anxiety is beneficial, and more limited evidence indicates that some anxiety screening instruments have acceptable accuracy to detect generalized anxiety disorder.
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Affiliation(s)
- Elizabeth A O'Connor
- Kaiser Permanente Evidence-based Practice Center, Kaiser Permanente Center for Health Research, Portland, Oregon
| | - Michelle L Henninger
- Kaiser Permanente Evidence-based Practice Center, Kaiser Permanente Center for Health Research, Portland, Oregon
| | - Leslie A Perdue
- Kaiser Permanente Evidence-based Practice Center, Kaiser Permanente Center for Health Research, Portland, Oregon
| | - Erin L Coppola
- Kaiser Permanente Evidence-based Practice Center, Kaiser Permanente Center for Health Research, Portland, Oregon
| | - Rachel G Thomas
- Kaiser Permanente Evidence-based Practice Center, Kaiser Permanente Center for Health Research, Portland, Oregon
| | - Bradley N Gaynes
- Gillings School of Global Public Health, University of North Carolina School of Medicine, Chapel Hill
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Koire A, Feldman N, Erdei C, Mittal L, Liu CH. Postpartum experiences among individuals with suspected and confirmed prenatal generalized anxiety disorder during the COVID-19 pandemic: Implications for help-seeking. Psychiatry Res 2023; 323:115169. [PMID: 36989907 PMCID: PMC10010836 DOI: 10.1016/j.psychres.2023.115169] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 03/09/2023] [Accepted: 03/12/2023] [Indexed: 03/15/2023]
Abstract
Prenatal generalized anxiety disorder (GAD) is a common and underdiagnosed condition with negative health consequences to both the pregnant individual and child. Here we studied the relationship between diagnosis and treatment status of GAD during pregnancy (no GAD diagnosis, suspected but not diagnosed, diagnosed but not treated, diagnosed and treated) during the COVID-19 pandemic and postpartum mental health outcomes, while considering the potential influence of individual psychological factors such as distress tolerance and resilience and the role of COVID-19-related health worries. In this sample of predominantly highly educated and white birthing individuals, one in five respondents experienced GAD during pregnancy and another one in six suspected GAD but was not diagnosed. Amongst those with a GAD diagnosis, 30% did not receive treatment. We found that those with a GAD diagnosis during pregnancy who did not receive treatment showed the highest levels of postpartum anxiety and depressive symptoms in the postpartum, even after controlling for covariates, and experienced the most COVID-19-related health worries. In comparison, individuals with a GAD diagnosis during pregnancy who received treatment experienced significantly lower anxiety symptom burden and depressive symptom burden, with a symptom burden similar to those without a confirmed or suspected diagnosis after controlling for individual psychological factors. We conclude that clinicians should strongly consider screening for and treating prenatal anxiety to prevent suboptimal postpartum mental health outcomes.
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Affiliation(s)
- Amanda Koire
- Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, USA 02115,Harvard Medical School, 25 Shattuck Street, Boston, MA, USA 02115
| | - Natalie Feldman
- Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, USA 02115,Harvard Medical School, 25 Shattuck Street, Boston, MA, USA 02115
| | - Carmina Erdei
- Harvard Medical School, 25 Shattuck Street, Boston, MA, USA 02115,Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, 221 Longwood Ave. Boston, MA, USA 02115
| | - Leena Mittal
- Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, USA 02115,Harvard Medical School, 25 Shattuck Street, Boston, MA, USA 02115
| | - Cindy H. Liu
- Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, USA 02115,Harvard Medical School, 25 Shattuck Street, Boston, MA, USA 02115,Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, 221 Longwood Ave. Boston, MA, USA 02115,Corresponding Author: Cindy H. Liu, Tel: 617-525-4131, 221 Longwood Ave., BLI 341, Boston, MA 02115
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Wang L, Yang N, Zhou H, Mao X, Zhou Y. Pregnant Women’s Anxiety and Depression Symptoms and Influence Factors in the COVID-19 Pandemic in Changzhou, China. Front Psychol 2022; 13:855545. [PMID: 35693497 PMCID: PMC9177387 DOI: 10.3389/fpsyg.2022.855545] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundWith the coronavirus disease 2019 (COVID-19) pandemic, pregnant women’s psychological conditions have become a global challenge. The aim of the study was to identify the prevalence of anxiety and depression symptoms and analyze their influence factors among pregnant women in Changzhou, China during the COVID-19 pandemic and provide them with appropriate healthcare strategies.MethodsParticipants were 681 pregnant women who visited various obstetrics and gynecology clinics in Changzhou, China between 25 February 2020 and 7 March 2020. They were asked to complete an online survey. The Generalized Anxiety Disorder Scale-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) were used to detect anxious and depressive symptoms. The chi-squared test and multivariate logistic regression analysis were carried out to examine the associated factors in these groups.ResultsOverall, the prevalence rates of anxiety and depression symptoms among pregnant women were 31.72 and 36.12%, respectively, but most of them were mild. Having an irregular diet with poor subjective sleep quality, perceiving little family support, spending too much time on news related to the coronavirus, and having severe subjective life impact by the coronavirus were related to anxiety and depression symptoms. In addition, lack of physical exercise and exposure to electronic screens over 5 h per day were associated with depression symptoms.ConclusionPregnant women with an irregular diet, poor sleep quality, little family support, excessive attention to COVID-19 news, and lives impacted by the coronavirus severely are at high risk for anxiety and depression symptoms during the COVID-19 pandemic. This indicates that targeted measures to address mental health in pregnant women during the pandemic period are needed.
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Affiliation(s)
- Li Wang
- Changzhou Maternal and Child Health Care Hospital, Changzhou, China
| | - Ni Yang
- Department of Obstetrics and Gynecology, Nanjing Medical University, Nanjing, China
| | - Hua Zhou
- Changzhou Maternal and Child Health Care Hospital, Changzhou, China
| | - Xueqin Mao
- Changzhou Maternal and Child Health Care Hospital, Changzhou, China
| | - Ying Zhou
- Changzhou Center for Disease Control and Prevention, Changzhou, China
- *Correspondence: Ying Zhou,
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Sinesi A, Cheyne H, Maxwell M, O'Carroll R. THE STIRLING ANTENATAL ANXIETY SCALE (SAAS): DEVELOPMENT AND INITIAL PSYCHOMETRIC VALIDATION. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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