Anxiety in Pregnancy and the Onset of Peripartum Depression: Evidence from Low-Risk Cohorts
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Background Peripartum depression is a prevalent condition associated with adverse maternal and infant outcomes, but often remains undiagnosed, especially among women without apparent risk factors. Despite growing recognition of the association of anxiety during pregnancy and peripartum depression, routine screening in low-risk populations is not standard practice. Methods A prospective cohort study was conducted among 214 low-risk pregnant women attending routine obstetric follow-ups at a tertiary hospital in central Israel between June 2020 and February 2021. Participants completed the Perinatal Anxiety Screening Scale and Edinburgh Postnatal Depression Scale prenatally and within six weeks postpartum. Sociodemographic and health-related data, including perceived birth experience, were also collected. Nonparametric tests and regression analyses were used to examine associations between anxiety and depression symptoms, sociodemographic variables, and perceived birth experience. Results Before birth, 38.8% of the participants reported experiencing anxiety symptoms, with 36.9% continuing to report postpartum anxiety symptoms. The prevalence of depression symptoms increased significantly from before birth (9.8%) to postpartum (15.9%). Prenatal anxiety symptoms significantly predicted postpartum depression symptoms. Perceived birth experience partially mediated the relationship between prenatal anxiety and postpartum depression among women with lower income-to-expenditure ratios. Conclusion A substantial proportion of low-risk women reported anxiety symptoms during pregnancy, and depression symptoms tended to worsen after childbirth. The significant association detected between prenatal anxiety symptoms and peripartum depression, even among low-risk women, emphasizes the need for public awareness and routine prenatal screening, incorporating psychological and contextual factors. Improving birth experience may help reduce postpartum depression risk especially for socioeconomically disadvantaged women.
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A prospective cohort study was conducted among 214 low-risk pregnant women attending routine obstetric follow-ups at a tertiary hospital in central Israel between June 2020 and February 2021. Participants completed the Perinatal Anxiety Screening Scale and Edinburgh Postnatal Depression Scale prenatally and within six weeks postpartum. Sociodemographic and health-related data, including perceived birth experience, were also collected. Nonparametric tests and regression analyses were used to examine associations between anxiety and depression symptoms, sociodemographic variables, and perceived birth experience.