Trends of Perinatal Stress, Anxiety, and Depression and Their Prediction on Postpartum Depression

Abstract

Perinatal stress, anxiety, and depression impacts not only women but also their child(ren). The purpose of this longitudinal study is to explore trends of stress, anxiety, and depressive symptoms from pregnancy to postpartum and understand predictions of stress and anxiety on postpartum depression. One-hundred-fifty-six women at 23–28 weeks gestation (T1), 147 at 32–36 weeks gestation (T2), 129 at over 36 weeks gestation (T3), and 83 at postpartum (T4) completed study surveys. The Perceived Stress Scale, Center for Epidemiologic Studies Depression scale, and State-Trait Anxiety Inventory were used to measure stress, depressive symptoms, and anxiety. Descriptive statistics, Pearson and Spearman’s correlation, and Generalized Estimating Equation were applied to analyze the data. Results showed that levels of anxiety and depressive symptoms increased from 24 weeks gestation to postpartum, whereas stress levels decreased during pregnancy but increased in postpartum. Over half of women experienced anxiety symptoms, especially during late pregnancy and postpartum. Stress, anxiety, and depressive symptoms were inter-correlated. Notably, women at late pregnancy and postpartum were prone to stress, anxiety, and depression. Prenatal anxiety could predict postpartum depressive symptoms. Active assessment and management of stress, anxiety, and depression is needed and should begin from early pregnancy and continue until postpartum.

The Efficacy of Digital Cognitive–Behavioral Interventions in Supporting the Psychological Adjustment and Sleep Quality of Pregnant Women with Sub-Clinical Symptoms: A Systematic Review and Meta-Analysis

“…The hyperactivity of the HPA, which is associated with heightened psychological stress, is deemed as one of the etiological factors leading to increased depression symptoms [ 7 , 8 ], which are highly comorbid with anxiety symptoms [ 9 , 10 ]. Indeed, depression, anxiety, and stress symptoms, beyond being highly interrelated [ 11 , 12 , 13 , 14 ], are all quite prevalent during pregnancy (depression: 15–65% [ 15 ]; anxiety: 18–24% [ 16 ]; stress: low–moderate 78% [ 17 ]), as well as during the postpartum period (depression: around 17% [ 18 ]; anxiety: around 15% [ 16 ]; stress: 20–40% [ 19 ]). The increased stress response and psychosocial symptoms during pregnancy jointly contribute to hindering women’s perinatal psychological adjustment and significantly increase the risk of developing postpartum depression [ 20 , 21 ].…”

COVID-19 affects psychological symptoms of pregnant women indirectly by increasing their maternal concerns

“…COVID-19 aggregates the worries of pregnant women, including pain and process of delivery, maturity of the fetus, and risk of infection to babies and themselves by COVID-19. Notably, prenatal anxiety was also a predictor for postpartum depressive symptoms ( Cheng et al, 2021 ). In addition, pregnant women's psychological health may affect fetal neurobehavioral development and child outcomes.…”

Construct of the Association between Sleep Quality and Perinatal Depression: A Literature Review

“…The literature shows that, as pregnancy progresses, sleep-related problems such as insomnia, daytime sleepiness, and poor sleep quality increase [ 29 ]. Pregnant women experience stress, anxiety, and depressive symptoms rising from 24 weeks to postpartum [ 30 ]. During regular prenatal care, signs of insomnia, difficulty in managing mental stress, and excessive preoccupation with pregnancy should be ruled out to reduce the rates of clinical depression and suicidal ideation [ 13 ].…”