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Postpartum anxiety increased maternal health care use, reduced breast-feeding duration

Women with postpartum anxiety are more likely to utilize maternal health care and reduce breast-feeding duration, new study findings suggest.

“Although postpartum depression is common and classically does not acutely present in the first days after childbirth, the major life event of childbirth and the immediate change in life roles and responsibilities after the birth of a child may be anxiety provoking,” the researchers wrote.

The researchers conducted a randomized controlled trial of 1,123 mothers (mean age, 29 years). Participants completed baseline interviews using the State Trait Anxiety Inventory (STAI) and the Edinburgh Postnatal Depression Survey (EPDS), and telephone interviews at 2 weeks, 2 months and 6 months after the birth of their child. STAI scores ≥40 and EPDS scores ≥12 were considered positive. All participants intended to breast-feed.

Nearly 200 (17%) of the participants had a positive baseline STAI and 6% had a positive baseline EPDS.

Researchers found that women with a positive STAI were more likely to use hospital-based services (P=.03), have unplanned outpatient visits (P=.008) and two or more overall provider visits (P<.001) within 14 days of childbirth. However, women with a positive EPDS were only more likely to have unplanned outpatient visits (P=.009) within 14 days of childbirth.

Reduced breast-feeding duration during the first 6 months was associated with a positive STAI score (P=.003) and a positive EPDS (P=.06), particularly in first-time mothers (P<.001) and those who underwent surgical deliveries (P=.03).

Positive STAI scores stayed relatively consistent, between 5.8% and 7.2%, at the follow-up assessments.

Of the women with a positive baseline STAI, 17.7% who completed the 2-week assessment still had a positive STAI. Among the 6% of women who had a positive baseline EPDS, 27.3% were still positive after 2 weeks. The overall cohort prevalence dropped at the 2- and 6-month assessments.

“Postpartum state anxiety is very common during the maternity hospitalization and is far more prevalent than depression in the first days after childbirth,” researchers wrote. “Its association with adverse maternal and child health outcomes makes it relevant for both maternal and pediatric health care providers who have ample opportunity to screen for state anxiety and potentially intervene, particularly among those most affected, such as first time mothers.”

Disclosure: The researchers report no relevant financial disclosures.