The role of maternal anxiety in the early postpartum period: screening for anxiety and depressive symptomatology in Greece

Abstract

Background: From birth to the first year postpartum, there is a critical period for the development of affective disorders. Maternal anxiety has received little attention even though it is associated with a number of adverse outcomes. Symptoms of anxiety often comorbid with depression and pertain a significant role in the maintenance of postpartum distress. The purpose of this study is to assess anxiety and depressive symptomatology in a Greek population and to examine their relationship. This study investigated the demographic and socio-psychological factors that are associated with the onset of the symptoms of postpartum distress.

Method: The study was conducted at the perinatal hospital Elena Venizelou in Greece. Two hundred thirty-five mothers met the inclusion criteria and participated in the study. The state-trait inventory was administered to screen symptoms of anxiety. It incorporates the state subscale that measures symptoms of temporal anxiety, and trait subscale that measures personality predisposition to anxiety. The Edinburgh postpartum depression scale (EPDS) inventory was administered to screen for symptoms of depression. The first assessment was conducted in 2-3 days after labor and the follow-up assessment was conducted in 3 months postpartum by telephone. A standard survey questionnaire was used for the purposes of collecting the demographic data.

Results: Symptoms of postpartum depression had 14.5% of mothers on the first screening and 4.6% at the follow-up (EPDS >or= 14). State anxiety symptoms were manifested by 22.9% of the sample on the first screening and 12.6% at the follow-up. Trait anxiety symptoms exhibited 24.6% of the sample on the first screening and 14.3% at the follow-up. There was comorbidity between the symptoms of anxiety and depression. The comorbidity was evident even when the anxiety subscale of the EPDS was removed. State anxiety was correlated with primiparity, admission to the NICU and negative experience of labor. Trait anxiety was correlated with the marital status of the mother. The symptoms of depression were correlated with the young age of the mother and negative experience of labor.

Conclusion: Symptoms of maternal anxiety are common after labor in Greece and persist in the early postpartum period. This finding suggests that the impact of maternal anxiety should be considered when studying postpartum distress. The comorbidity amongst anxiety and depressive symptomatology persisted at 3 months postpartum making women more vulnerable to postpartum distress. Given this result screening prior to hospital discharge is essential as it can provide an indication of the mothers who are susceptible to developing affective disorders.