Background:
Most studies investigating maternal mood across the transition from pregnancy to the postnatal period have focused on depression. In contrast, little is known about patterns of anxiety across this period. This study aimed to 1) assess patterns of anxiety and depression across pregnancy and the postpartum, 2) investigate associations between antenatal mood and HPA axis hormones and 3) determine the extent to which antenatal anxiety, depression and HPA axis activity predict postnatal mood disorders.
Methods:
Participants were recruited antenatally as part of a prospective study undertaken at the Royal Hospital for Women, Sydney. Ninety-four women completed self-report measures of anxiety and depression at 30–32 and 36-38 weeks gestation, and at 6 months postpartum. They were also administered a structured diagnostic interview (MINI-Plus) at 36-38 weeks gestation and at 6 months postpartum to determine the presence of DSM-IV anxiety and depression. Blood samples were collected at 30–32 weeks gestation for bioassays of HPA axis hormones (CRH, ACTH and cortisol).
Results:
The data indicate significant stability in maternal mood across pregnancy and the postpartum and associations between anxiety and depression were moderate-high at each assessment. Despite the stability of depression, an anxiety disorder in pregnancy appears to be a greater risk factor for a postnatal anxiety [odds ratio (OR) = 10.20, P < 0.005] or depressive disorder (OR = 7.90, P < 0.005) than antenatal depression. Antenatal neuroendocrine parameters were unrelated to either antenatal or postnatal anxiety or depression.
Conclusion:
These results clearly highlight the importance of anxiety in both the pre- and postnatal periods.
