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Int J Environ Res Public Health. 2019 Aug 9;16(16). pii: E2851. doi: 10.3390/ijerph16162851.

What If Pregnancy Is Not Seventh Heaven? The Influence of Specific Life Events during Pregnancy and Delivery on the Transition of Antenatal into Postpartum Anxiety and Depression.

Author information

1
Department of Epidemiology, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands. j.l.aris@umcg.nl.
2
Department of Clinical Psychology, University of Groningen, 3584 CS Groningen, The Netherlands.
3
Department of Clinical and Health Psychology, Utrecht University, 3512 JE Utrecht, The Netherlands.
4
Department of Epidemiology, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands.
5
Department of General Practice, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands.
6
Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands.
7
Department of Obstetrics and Gynecology, OLVG, 1011 BM Amsterdam, The Netherlands.
8
Department of General Practice, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands. h.burger@umcg.nl.
9
Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands. h.burger@umcg.nl.

Abstract

INTRODUCTION:

Postpartum symptoms of anxiety and depression are known to have a negative impact on mother and child, and major life events constitute a major risk factor for these symptoms. We aimed to investigate to what extent specific life events during pregnancy, delivery complications, unfavorable obstetric outcomes, and antenatal levels of anxiety or depression symptoms were independently associated with postpartum levels of anxiety and depression symptoms.

METHODS:

Within a prospective population-based cohort study (n = 3842) in The Netherlands, antenatal symptoms of anxiety or depression were measured at the end of the first trimester and at five months postpartum. Antenatal life events were assessed during the third trimester, and information on delivery and obstetric outcomes was obtained from midwives and gynecologists. Linear regression analyses were performed to quantify the associations.

RESULTS:

Antenatal levels of both anxiety and depression symptoms were associated with postpartum levels of anxiety and depression symptoms. Life events related to health and sickness of self or loved ones, to the relation with the partner or conflicts with loved ones, or to work, finance, or housing problems were significantly associated with higher postpartum levels of anxiety symptoms (p < 0.001) and depression symptoms (p < 0.001) adjusted for antenatal levels. No statistically significant results were observed for pregnancy-related events, delivery complications, or unfavorable obstetric outcomes.

CONCLUSIONS:

Women with increased antenatal levels of anxiety or depression symptoms are at increased risk of elevated levels of both postpartum depression and anxiety symptoms. Experiencing life events during pregnancy that were not related to the pregnancy was associated with higher levels of anxiety and depression in the postpartum period, as opposed to pregnancy-related events, delivery complications, or unfavorable obstetric outcomes. These results suggest that events during pregnancy but not related to the pregnancy and birth are a highly important predictor for postpartum mental health.

KEYWORDS:

antenatal anxiety and depression symptoms; life events; mode of delivery; neonatal outcomes; postpartum anxiety and depression symptoms

PMID:
31405014
PMCID:
PMC6720783
DOI:
10.3390/ijerph16162851
[Indexed for MEDLINE]
Free PMC Article

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