Postpartum anxiety in a cohort of women from the general population: risk factors and association with depression during last week of pregnancy, postpartum depression and postpartum PTSD.
BACKGROUND
In contrast to postpartum depression, postpartum anxiety receives less attention, especially in the general population. Acknowledging the phenomenon is important, as it may lead to significant distress and impair maternal functioning.


OBJECTIVE
To explore the phenomenon in a cohort of women in the general population and to investigate possible associated factors.


METHODS
Within the first days after childbirth, women at Chaim Sheba Medical Center maternity ward were interviewed. Questionnaires included psychosocial variables, feelings and fears during pregnancy and childbirth, and the Edinburgh Postnatal Depression Scale (EPDS) (referring to the last week before delivery). A month later, subjects completed the EPDS, a modified Spielberger Anxiety Scale and the Posttraumatic Stress Diagnostic Scale via telephone.


RESULTS
40.4% had high anxiety scores. A significant association was noted between postpartum anxiety and depression during the last week of pregnancy, postpartum depression, as well as postpartum PTSD. Anxiety scores were almost 50% higher in those who suffered from postpartum PTSD compared to those who experienced postpartum depression. Associations were also found with fear of the birth, fear of death during delivery (mother and fetus), feeling lack of control during labor and less confidence in self and medical staff. Of women who developed postpartum anxiety, 75% reported feeling anger, fear or emotional detachment during childbirth. No association was found with birth complications.


CONCLUSIONS
Anxiety symptomatology appears to be a common manifestation after childbirth. It is therefore important to inquire about depression and fears during pregnancy and childbirth and subjective experience in order to anticipate postpartum anxiety symptoms, even by means of a brief screening test. The finding that postpartum PTSD was associated with the severity of postpartum anxiety may be used in the future as a potential identifier of PTSD symptoms in women with high anxiety scores.
Beer Yaakov-Ness Ziona Mental Health Center, Beer Yaakov, Israel.
Inbal
I
Shlomi Polachek
Ramat Chen Community Mental Health Center, Ramat Hatayasim, Tel Aviv, Israel.
Liat
L
Huller Harari
Sheba Medical Center at Tel Hashomer, Ramat Gan, Israel.
Micha
M
Baum
Beer Yaakov-Ness Ziona Mental Health Center, Beer Yaakov, Israel Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.
Rael D
RD
Strous
D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology*; D015331:Cohort Studies; D019052:Depression, Postpartum / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D049590:Postpartum Period / Q000523:psychology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000523:psychology*; D011644:Puerperal Disorders / Q000453:epidemiology / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000523:psychology*; D055815:Young Adult