title: Associations of life events during pregnancy with longitudinal change in symptoms of antenatal anxiety and depression.
abstract: OBJECTIVE
  to investigate the association of life events during pregnancy with change in antenatal anxiety and depression symptoms. We distinguished pregnancy related and non-pregnancy related events and assessed specificity of these associations for depressive or anxious symptoms. In addition, we investigated whether the associations were affected by personality or childhood adversities.
  
  
  METHODS
  observational prospective cohort study
  
  
  METHODS
  primary and secondary obstetric care centres in the Netherlands
  
  
  METHODS
  1603 women during their first trimester of pregnancy between May 2010 and May 2012 MEASUREMENTS AND FINDINGS: we performed linear regression analyses to test the associations of pregnancy related, non-pregnancy related life events, childhood adversities and the personality traits neuroticism and extraversion with the change in symptoms of anxiety (State Trait Anxiety Inventory) and depression (Edinburgh Postnatal Depression Scale) from week 12 to week 36. Life events during pregnancy were associated with increasing antenatal symptoms of anxiety and depression. Effect sizes associated with the highest numbers of events observed ranged from 0.59 to 1.31. Pregnancy related events were specifically associated with increasing symptoms of anxiety (p=0.009), whereas non-pregnancy related events were merely associated with an increase in symptoms of depression (p<0.001). Neither personality traits nor childhood trauma influenced the associations under study.
  
  
  CONCLUSIONS
  the most important finding is that pregnancy related life events during pregnancy increase levels of antenatal anxiety, whereas depression levels increase when women experience life events that are unrelated to pregnancy. Furthermore, non-pregnancy related events show stronger associations with increases in symptoms of anxiety or depression compared to pregnancy related events.
  
  
  CONCLUSIONS
  our findings may help midwives to tailor psychosocial care to the specific risks of the pregnant woman which may eventually have a positive impact on the health of mother and child.
authors.affiliation: Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Judith L
authors.initials: JL
authors.lastname: Meijer
authors.affiliation: Department of Clinical and Developmental Psychology, University of Groningen, Groningen, The Netherlands.
authors.forename: Claudi L H
authors.initials: CL
authors.lastname: Bockting
authors.affiliation: Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Ronald P
authors.initials: RP
authors.lastname: Stolk
authors.affiliation: Department of Psychiatry, Stony Brook University Medical Center, Stony Brook, NY, USA.
authors.forename: Roman
authors.initials: R
authors.lastname: Kotov
authors.affiliation: Interdisciplinary Center Psychopathology and Emotion regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Johan
authors.initials: J
authors.lastname: Ormel
authors.affiliation: Department of General Practice, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands. Electronic address: h.burger@umcg.nl.
authors.forename: Huibert
authors.initials: H
authors.lastname: Burger
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000453:epidemiology / Q000209:etiology*; D001526:Behavioral Symptoms; D003863:Depression / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008016:Life Change Events; D008875:Middle Aged; D011247:Pregnancy / Q000523:psychology*; D055815:Young Adult
keywords: Anxiety; Depression; Life change events; Pregnancy