The relationship of cumulative psychosocial adversity with antepartum depression and anxiety

Abstract

Background Exposure to multiple psychosocial risk factors may increase vulnerability for mental health conditions during pregnancy. This analysis examined the relationship of a novel psychosocial adversity index with the co‐occurrence and persistence of depression and anxiety throughout pregnancy. Methods This cross‐sectional analysis included 1797 pregnant women screened in the second/third trimesters for depression and anxiety symptoms and for eight contextual and individual psychosocial factors. The factors were summed to create a psychosocial adversity index; reporting four or more factors indicated high adversity. Elevated symptoms in both trimesters indicated persistent depression/anxiety and elevated symptoms at the same trimester indicated comorbid symptoms. The associations between the psychosocial adversity index and mental health were estimated. Results Compared with a low psychosocial adversity index, women reporting a high level of psychosocial adversities had 2.06 (95% confidence interval [CI]: 1.51–2.82) times higher adjusted odds of only depressive or anxiety symptoms, and 5.57 (95% CI: 3.95–7.85) times higher adjusted odds of comorbid symptoms. The associations for persistent symptoms were of similar direction and magnitude. Conclusion High psychosocial adversity was associated with persistent and comorbid depressive symptoms and anxiety during pregnancy. Assessing psychosocial adversity can help identify women at increased risk who would benefit from tailored mental health interventions.

Assessment of Psychosocial and Neonatal Risk Factors for Trajectories of Behavioral Dysregulation Among Young Children From 18 to 72 Months of Age

“…Emotional and behavioral dysregulation among school-aged children has an average multinational prevalence of 9% (range, 2%-18%; n = 56 666) and is associated with subsequently severe behavioral, affective, and cognitive impairments through adulthood . Risk factors for children’s persisting emotional and behavioral dysregulation involve the cumulative burden of medical and socioeconomic adversities, as well as parental psychological and substance use challenges …”

“…[2][3][4] Risk factors for children's persisting emotional and behavioral dysregulation involve the cumulative burden of medical and socioeconomic adversities, as well as parental psychological and substance use challenges. [5][6][7][8][9][10][11] Children born preterm (<37 weeks' gestation), and children whose parents have co-occurring psychological and substance use challenges are at elevated risk for persisting dysregulation. [12][13][14][15][16] Moreover, prematurity, in combination with environmental adversity has been associated with childhood anxiety, attention, mood, and social-communicative disorders that persist into adulthood.…”

“… 2 , 3 , 4 Risk factors for children’s persisting emotional and behavioral dysregulation involve the cumulative burden of medical and socioeconomic adversities, as well as parental psychological and substance use challenges. 5 , 6 , 7 , 8 , 9 , 10 , 11 …”

Risk Factors for Postpartum Depression and Severe Distress among Mothers of Very Preterm Infants at NICU Discharge

“…Further, we sought to address a knowledge gap by identifying maternal needs that emerge in the time between routine prenatal care assessments, PPD screening in the context of routine postpartum obstetric follow-up, and in follow-along pediatric care. Building on earlier studies, 17 26 we hypothesized that PPD and SPD would be associated with prior depression and/or anxiety, prenatal substance use, and more extensive medical and socioenvironmental adversities. To our knowledge, this is the first multicenter study to examine these risk factors in concert in a large and diverse sample of mothers who delivered a very preterm infant (<30 weeks gestation), and to describe the relative associations between psychological history, substance use, and socioenvironmental conditions, as well as maternal and infant medical complications with PPD and SPD at NICU discharge.…”