Thursday, March 31, 2016

Negative View of Birth Experience Found to Be Associated With Elevated Postpartum Anxiety


A more negative perception of a recent childbirth experience is associated with elevated symptoms of postpartum anxiety, but not postpartum depression, according to a study in the April issue of the Archives of Women’s Mental Health.

The findings suggest that improving the childbirth experience for women may help to reduce postpartum anxiety, which is believed to affect some 13 to 19 percent of women during the first year following childbirth. Past studies show that postpartum depression and anxiety can compromise mother-infant interactions and child development.

To determine whether childbirth factors such as mode of birth, interventions, complications, and women’s experience are associated with elevated symptoms of depression and anxiety, researchers from the United States and United Kingdom examined the medical records from a sample of nearly 5,000 women living in the United Kingdom who gave birth between April 1991 and December 1992 and participated in the Avon Longitudinal Study of Parents and Children. The Edinburgh Postnatal Depression Scale was used to assess elevated symptoms of depression (score of greater than or equal to 13) and the Crown-Crisp Experiential Index was used to assess elevated symptoms of anxiety (score greater than or equal to 9) at two and eight months after delivery. The researchers compared women who described the recent birth experience as “wonderful” with those who described it as “not wonderful/not sure.”

A more negative perception of the birth experience was associated with elevated symptoms of anxiety at two months (odds ratio [OR]=1.52) and eight months (OR=1.30) postpartum but was not associated with elevated symptoms of depression at either time point. Type of delivery (physiological [defined as no drug exposure except nitrous oxide] versus non-physiological [interventions of pain medication, oxytocin, cesarean]) and immediate postpartum complications were not associated with elevated symptoms of depression or anxiety.

“Reducing postpartum anxiety will likely improve mother-infant interaction and infant development and may even reduce the incidence of posttraumatic stress related to childbirth,” the authors wrote. “Given the known psychosocial risk factors of postpartum depression; the emerging research on hormonal, genetic, and epigenetic biomarkers of depression; and the frequent comorbidity of postpartum depression and anxiety, future research is warranted to identify psychosocial and biological risk factors unique to postpartum anxiety.”

For related information, see the Psychiatric News article “Early Postpartum Depression Screenings Not Enough to Identify High-Risk Women.”

(Image: iStock/nattrass)

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