title: Anxiety and depression during pregnancy in Central America: a cross-sectional study among pregnant women in the developing country Nicaragua.
abstract: BACKGROUND
  Around the world, maternal psychopathology during pregnancy is associated with a range of negative consequences for mother and child. Nevertheless, in Central America the magnitude of this public health problem is still unknown. The objective of this first explorative study was to investigate the prevalence and severity of anxiety and depression during pregnancy in the Central American developing country Nicaragua, as well as the availability of mental health care and to compare with a developed country.
  
  
  METHODS
  A population-based cohort of pregnant women in Nicaragua (N = 98) was compared with a parallel cohort in the Netherlands (N = 4725) on symptoms of anxiety (Spielberger State Trait Anxiety Inventory) and depression (Edinburgh Postnatal Depression Scale). Associations with the women's knowledge how to reach professional psychological support were assessed using multivariable linear regression analyses.
  
  
  RESULTS
  Of the Nicaraguan women, 41 % had symptoms of anxiety and 57 % symptoms of depression, versus 15 % and 6 % of the Dutch women. Symptom scores of both anxiety and depression were significantly higher in Nicaragua (p < 0.001). However, only 9.6 % of the women indicated that professional psychological help was available for the Nicaraguan pregnant women, which was associated with an increased anxiety score.
  
  
  CONCLUSIONS
  In Nicaragua, both prevalence and severity of symptoms of antenatal anxiety and depression are substantially higher than in developed countries. However, availability of psychological help is very limited for pregnant Nicaraguan women. These findings indicate that there is need for further research and support for these women, to prevent negative consequences for both mother and child.
authors.affiliation: Department of Epidemiology, University of Groningen, University Medical Center Groningen, HPC FA40, Postbus 30.001, 9700, RB, Groningen, The Netherlands. t.verbeek@umcg.nl.|Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. t.verbeek@umcg.nl.
authors.forename: T
authors.initials: T
authors.lastname: Verbeek
authors.affiliation: Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Arjadi
authors.affiliation: Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: J J
authors.initials: JJ
authors.lastname: Vendrik
authors.affiliation: Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: Burger
authors.affiliation: Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: M Y
authors.initials: MY
authors.lastname: Berger
mesh_terms: D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000523:psychology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology*; D003906:Developing Countries / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D009426:Netherlands / Q000453:epidemiology; D009527:Nicaragua / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D037841:Pregnant People / Q000523:psychology; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult