Comparison between prenatal and postpartum depression and anxiety: What makes the most differences?

Background: Perinatal depression and anxiety affect approximately 6.6-25% of women. Although previous studies identify risk factors for perinatal depression, much fewer focuses on anxiety. This study thus aims to compare the prevalence and risk factors for prenatal and postpartum depression and anxiety, with the differences identified. Methods: A total of 598 pregnant women with prenatal visits from August, 2011 in selected hospitals are recruited for participation. Self-reported data are collected in the hospitals using questionnaires of the Edinburgh Postnatal Depression Scale, State-Trait Anxiety Inventory, together with other potential risk factors (e.g., fetal gender, parental stress, marital adjustment, pregnancy intention, lifestyle). Multivariate regression models are used for analyses. Results: It is observed that 20.1% of pregnant mothers experience high level of depression, while 34% have moderate to high level of anxiety. During postpartum period, the prevalence of depression is about 28.6%, as the rate of anxiety is approximately 33.4%. Higher parental stress (OR=3.38, 95%CI=(1.81-6.32)) and poorer marital adjustment (OR=3.01,95%CI=(1.81-5.0)) are independently associated with antenatal anxiety. The strengths of the association are stronger for anxiety than depression. However, female fetus is not associated with either antenatal depression or anxiety. Differences in other risk factors are found and compared for perinatal depression and anxiety. Conclusions More women experience postpartum depression, in reference to prenatal depression. However, rates of perinatal anxiety are even higher than those of depression. As prenatal depression and anxiety are prevalent and deserve continued attention, various risk factors identified should be applied in different programs targeting on various populations.