The prevalence and associated factors of prenatal depression and anxiety in twin pregnancy: a cross-sectional study in Chongqing, China

Abstract

Background Pregnant women expecting twins are more likely to experience stress, which can lead to anxiety and depression. Our aim was to investigate the prevalence of prenatal anxiety and depressive symptoms in women with twin pregnancies and the associated factors. Methods In a cross-sectional survey, 210 women with twin pregnancies who satisfied the inclusion and exclusion criteria in two tertiary centers in Southwestern China were asked to complete a basic information form, the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS). To compare statistics with normal distribution in distinct characteristic groups, a paired t-test, and one-way ANOVA were utilized. Binary logistic step regression was used to analyze the associated factors of antenatal anxiety and depressive symptoms. Results The 210 women with twin pregnancies (age = 30.8 ± 4.2 years) were between 7 and 37 gestational weeks (29.2 ± 1.2 weeks), were typically well-educated (72.4% had a post-high-school degree), and reasonably affluent (88.1% were above the low-income cutoff). Among them, 34.8% had symptoms associated with clinical levels of anxiety, and 37.1% had symptoms indicating possible depression. The prevalence of co-morbid anxiety and depressive symptoms was 24.3%. Binary stepwise logistic regression analysis showed that previous health status and sleep disturbance during pregnancy were the associated factors of anxiety symptoms in women with twin pregnancies (P < 0.05), whereas age, previous health status, negative life events, and physical activity during pregnancy were the associated factors of depressive symptoms in women with twin pregnancies (P < 0.05). Conclusion About one-third of women with twin pregnancies had symptoms of anxiety or depression; these were most strongly predicted by some modifiable factors, suggesting that early preventive mind-body interventions may be a promising strategy to protect against mental health issues for women with twin pregnancies.

Prevalence of Perinatal Anxiety and Related Disorders in Low- and Middle-Income Countries

“…This subgroup included only 9 studies, all of which were performed in Turkey. The lowest prevalence was found in East Asia and the Pacific (12.7%; 95% CI, 10.5%-15.1%; 61 studies; n = 103 180). Of the studies conducted in East Asia and the Pacific, 53 (86.9%) were conducted in China (eFigure 7 in Supplement 1).…”

“…While investigating generalized anxiety by country income status, we found a higher prevalence among studies performed in lower-middle–income countries (27.6%; 95% CI, 21.6%-33.9%; 59 studies; n = 25 109) compared with low-income countries (24.0%; 95% CI, 15.3%-33.8%; 11 studies; n = 4961). Upper-middle–income countries had the lowest prevalence (19.1%; 95% CI, 16.0%-22.4%; 110 studies; n = 138 496).…”

“…Generalized anxiety disorder (including anxiety not specified) was the most commonly reported anxiety disorder, examined by 184 of 203 studies (90.6%) . The pooled point prevalence for generalized anxiety disorder was 22.2% (95% CI, 19.4%-25.0%; n = 173 553).…”

“…Our search identified 10 617 studies; 1231 full texts were reviewed, and of these, 203 studies were included (Figure 1; eTable 2 in Supplement 1). Cumulatively, outcomes were reported for 212 318 perinatal women (from conception to 12 months post birth) from 33 LMICs. The prevalence estimates of 6 anxiety and related disorders were reported: generalized anxiety disorder, social anxiety disorder, posttraumatic stress disorder, obsessive-compulsive disorder, panic disorder, and adjustment disorder.…”

“…The majority of studies reported the prevalence of generalized anxiety antenatally (150 [81.5%]). Among these, the pooled point prevalence was 23.9% (95% CI, 20.5%-27.4%; n = 149 485).…”