Relevance of anxiety in the perinatal period: prospective study in a Hungarian sample

Abstract

There is increasing evidence that anxiety occurs frequently during pregnancy and can be one of the most important risk factors and predictors of postpartum depression (PPD). The aim of our study was to investigate whether antenatal anxiety is an independent predictor of PPD. We used the data of 476 women enrolled in a prospective study in a single maternity unit. The first assessment was conducted between 22 and 40 weeks gestation and a second time 8–12 months postpartum. Symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS) and the State Trait Anxiety Inventory (STAI). Based on our results, antenatal anxiety measured by a subscale of EPDS has predicted better PPD than the antenatal depressive subscale. However, the most relevant predictor of PPD might be the trait anxiety level of a women measured by STAI Trait Scale, whereas a cutoff value of 38 was identified to indicate higher risk of PPD.

Keywords:

• Postpartum depression
• trait anxiety
• EPDS
• STAI

Acknowledgements

The authors thank all the women who participated in the study.

Disclosure statement

The authors declare no conflict of interest.

Current knowledge on the subject

• Antenatal anxiety may be even more common than depression.

• Adequate assessment of pregnancy anxiety is a key issue.

• Incidence data on anxiety disorders during pregnancy often cite retrospective studies with small sample sizes.

What this study adds

• A population-based, prospective follow-up design was carried out with reasonable numbers of women with PPD symptoms and with detailed data for maternal mental health in terms of trait anxiety and depressive symptoms during pregnancy.

• Trait anxiety and anxiety symptoms during pregnancy were significantly associated with PPD at 8–12 months postpartum, independently of the existence of antenatal maternal depression.

• One of the most relevant predictor of PPD might be the general anxiety level of a woman.