Hoberg MG, Demirci JR, Sereika SM, Levine MD, DeVito Dabbs A. Descriptive Exploratory Study to Understand Postpartum Anxiety Using Multiple Measures.
J Obstet Gynecol Neonatal Nurs 2023;
52:50-61. [PMID:
36356652 PMCID:
PMC9839497 DOI:
10.1016/j.jogn.2022.09.003]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 09/07/2022] [Accepted: 09/15/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE
To compare a general anxiety instrument plus a depression instrument with a specific postpartum anxiety instrument plus a depression instrument to detect postpartum anxiety and to explore trends in daily postpartum anxiety.
DESIGN
Prospective, longitudinal cohort study.
SETTING
Academic tertiary center in the mid-Atlantic United States. Study activities were remote.
PARTICIPANTS
Pregnant women (N = 73) in the third trimester of pregnancy.
METHODS
We administered the State-Trait Anxiety Inventory (STAI), Postpartum Specific Anxiety Scale (PSAS), and Edinburgh Postnatal Depression Scale (EPDS) at 1 and 8 weeks after birth. We used mobile ecological momentary assessment prompts to measure daily anxiety levels (0-10) from 1 to 8 weeks after birth. We defined the presence of anxiety and depression by using the established instrument cutoff scores. We used repeated-measures analysis of variance and dependent-samples t tests to determine the stability of the determined anxiety instruments during the study time frame. We used linear mixed modeling to explore mobile ecological momentary assessment anxiety trends.
RESULTS
The PSAS and EPDS detected more participants with anxiety and/or depression (26.8%, 19/71) than the STAI and EPDS (23.9%, 17/71) at 8 weeks after birth. PSAS scores increased from 1 to 8 weeks after birth (p = .003); STAI scores decreased (p = .01). Daily anxiety ratings changed nonlinearly during the study period, were greatest at 2 weeks, declined and stabilized, and then trended upward toward Week 8.
CONCLUSION
Detection of postpartum anxiety in clinical settings can be improved through addition of the PSAS in routine screening. Timing of anxiety assessment should be considered between 6 to 8 weeks after birth.
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