Observational study of mental health in asthmatic women during the prenatal and postnatal periods

Abstract

Objective: We aimed to examine the prevalence and severity of psychological distress of women with asthma in both the prenatal and postnatal periods, and to determine whether asthmatic women with and without mental health problems differ in self-management, medications knowledge, and asthma symptoms.

Methods: We assessed spirometry performance and asthma symptoms in 120 women (mean age 29.8 years) before 23 weeks gestation, as part of the Breathing for Life Trial (Trial ID: ACTRN12613000202763). Prenatal depression data was obtained from medical records. At 6 weeks postpartum, we assessed general health, self-reported asthma control, depression symptoms (with the Edinburgh Postnatal Depression Scale) and adaptive functioning (with the Achenbach System of Empirically Based Assessment scales).

Results: Twenty percent of our sample reported having a current mental health diagnosis, 14% reported currently receiving mental health care, while 47% reported having received mental health care in the past (and may/may not have received a diagnosis). The sample scored high on the Aggressive Behavior, Avoidant Personality, and Attention Deficit/Hyperactivity scales. Poorer self-reported postnatal asthma control was strongly correlated with elevated somatic complaints, externalizing problems, antisocial personality problems, and greater withdrawal. Prenatal spirometry or asthma severity and control were largely not associated with measures of psychopathology.

Conclusions: These findings indicate that pregnant women with asthma frequently report issues with psychopathology during the prenatal and postnatal periods, and that the subjective perception of asthma control may be more related to psychopathology than objective asthma measures. However, due to sample bias, these findings are likely to be understated.

Keywords:

• Prenatal depression
• postnatal depression
• psychopathology
• adaptive functioning
• asthma during pregnancy
• asthma severity
• asthma control

Acknowledgements

We would like to thank the staff of the antenatal clinics at the John Hunter Hospital for assistance with patient recruitment and clinical assessment, and specifically Kelly Steel, Kathryn Jesson and Patricia Belinelo for assistance with assessment. We acknowledge Kathryn Jesson and Dr Ana Pereira de Siqueira for their role in smoothly organizing the transfer of participants from the BLT to the BLT-ID study. We thank all women who participated in the studies. We thank Annelies Robijn for assistance with data access.

Financial Disclosure Statement

This project was a sub-study within a larger clinical randomized control trial. The sub-study, the Breathing for Life- Infant Development study, was conducted with financial assistance from the Priority Research Center GrowUpWell at The University of Newcastle.

The randomized control trial from which our participants were recruited, the Breathing for Life Trial, was supported by the National Health and Medical Research Council of Australia ($1,114 750), grant no. G1400050. This grant was awarded to VM, alongside a large team. Trial registration number is ACTRN12613000202763. Further information can be found at https://www.australianclinicaltrials.gov.au/anzctr/trial/ACTRN12613000202763.

CM, AW and OW were supported by a Research Training Program Stipend Scholarship Provided by the Australian Government. VM was supported by a Career Development Fellowship from the NHMRC (grant ID 1084816).

The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.