Coping strategies during pregnancy and their relationship with anxiety and depression

ABSTRACT

How individuals perceive and cope with stressful situations may determine their level of anxiety or depression. The identification of coping strategies (CS) in pregnancy could help prevent depression and anxiety (D&A), and their consequent effects on the health of the mother and the baby. A cross-sectional descriptive correlational study was conducted to identify the CS most commonly used by pregnant women in a Spanish population and to evaluate the association of these CS with D&A. A consecutive sample of 282 pregnant women over 18 years of age were recruited when attended midwife consultations and through snowball sampling between December 2019 and January 2021 in the Basque public health system. CS were measured using the RevisedPrenatal Coping Inventory (NuPCI) questionnaire, assigning the score to an avoidant, preparatory or spiritual scale. Cutoff points were established to categorize anxiety and depressive symptomatology, using the STAI-S and EPDS scales. Multivariate logistic regression models were constructed to analyze the association between CS and D&A. The results show that the higher the score on the avoidance subscale, the higher the likelihood of having an anxiety disorder (OR: 8.88  (95 percent Confidence Interval [CI] 4.26–20.1), and depressive symptoms (OR: 8.29 (95 percent CI 4.24–17.4). Multiparous women are more likely to have anxiety (OR: 3.41  (95 percent CI 1.58–7.5) or depressive symptomatology (OR: 4.1 (95 percent CI 2.04–8.53) during pregnancy. These results highlight the need to consider the evaluation of CS used during pregnancy to tailor the care provided, but further studies on the implementation and effectiveness of interventions are needed.

KEYWORDS:

• Anxiety
• coping
• coping strategies
• depression
• midwifery
• pregnancy

Acknowledgments

We would like to thank all pregnant women who have responded to the questionnaires in this study and the midwives; Sonia Alvarez, Pilar Amorrortu, Mónica Blas, Inés Cabeza, Itziar Estalella, Ana Cristina Fernández, Gloria Gutiérrez de Terán-Moreno, Kata Legarra, Gorane Lozano, Amaia Maquibar, David Moreno-López, María Jesús Mulas, Covadonga Pérez, Angela Rodríguez, Mercedes Sáenz de Santamaría, Jesús Sánchez and Gema Villanueva, who have carried out the recruitment work on behalf of the ema-Q group.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

We appreciate the grant received by the Institute of Health Carlos III, file number PI20/00899, within the State R&D&I Plan 2017–2020 and co-financed by the ISCII – Subdirectorate – General Evaluation and Promotion of Fund Research European Regional Development Fund (FEDER). This study has been co-financed by the Basque Government Department of Health [File n°: 2018111087], and its realization has been possible thanks to the management of the Biocruces-Bizkaia Health Research Institute.