Postpartum anxiety: prevalence and risk factors

Purpose: postpartum anxiety (PPA) is highly prevalent and has important consequences on mother and newborn. The aim of the present study was to estimate the prevalence of PPA and its risk factors, in a sample of women attending a private setting. Methods: a cross-sectional study was performed with 299 women, at a routine gynecological visit, from August 2000 to May 2003. The Spielberger State-Trait Anxiety Inventory (STAIT) and a questionnaire with sociodemographic data and obstetric data were used. Inclusion criteria were: women with no past or present history of depression, psychiatric treatment, alcohol or drug abuse and whose children were alive. The prevalences of PPA-trace and PPA-state, that evaluate characteristics of personality and transitory anxiety, respectively, were estimated with 95% confiance intervals (CI). Odds ratios and 95% CI were used to examine the association between PPA and exposure variables. Hypothesis testing was done by the chi(2) test or chi(2) test for linear trend, when categories were ordered. A p value < 0.05 was considered to be statistically significant. Results: the prevalences of PPA-state and PPA-trace were 44.8% (CI 95%: 39.1 - 50.7) and 46.1% (CI 95%: 40.4 - 52.0, respectively). Formal agreement between scales was moderate (kappa = 0.55; p <= 0.001). By univariate analysis, lower mother income and presence of newborn complications were associated with PPA-state and PPA-trace. Lower maternal age and greater number of alive children were associated with PPA-trace and PPA-state, respectively. By multivariate analysis, PPAtrace and PPA-state were associated with higher mother income (OR: 0.39; IC 95%: 0.21 - 0.74, p=0,005; OR: 0.46; IC 95%: 0.24 - 0.87, p=0.02) and presence of complications in newborns (OR: 2.15; IC 95%: 1.02 - 4.54, p=0.04) ( OR: 2.47; IC 95%: 1.16 - 5.25, p=0.02), respectively. PPA-trace was associated with greater maternal age (OR: 0.34; IC 95%: 0.13 - 0.88, p=0.008), while PPA-state was associated with greater number of alive children (OR: 1.82; IC 95%: 1.01 - 3.29, p=0.04). Conclusions: PPA was highly prevalent in this sample of women attending a private setting. Higher mother income and greater maternal age decrease the risk of AP, while presence of complications in newborns and greater number of alive children increase the risk.