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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2021

01-12-2021 | Mood Disorders | Research

The association between social support and antenatal depressive and anxiety symptoms among Australian women

Authors: Asres Bedaso, Jon Adams, Wenbo Peng, David Sibbritt

Published in: BMC Pregnancy and Childbirth | Issue 1/2021

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Abstract

Background

Antenatal depression and antenatal anxiety adversely affect several obstetric and foetal outcomes, and increase the rate of postnatal mental illness. Thus, to tackle these challenges the need for social support during pregnancy is vital. However, an extensive literature search failed to show a published study on the relationship between domains of social support and antenatal depressive, as well as antenatal anxiety symptoms in Australia. This study examined the association between domains of social support and antenatal depressive and anxiety symptoms among Australian women.

Methods

The current study used data obtained from the 1973–78 cohort of the Australian Longitudinal Study on Women’s Health (ALSWH), focusing upon women who reported being pregnant (n = 493). Depression and anxiety were assessed using the 10 item Center for Epidemiological Studies Depression (CES-D-10) scale, and the 9-item Goldberg Anxiety and Depression scale (GADS) respectively. The 19 item-Medical Outcomes Study Social Support index (MOSS) was used to assess social support. A logistic regression model was used to examine the associations between domains of social support and antenatal depressive and anxiety symptoms after adjusting for potential confounders.

Result

The current study found 24.7 and 20.9% of pregnant women screened positive for depressive and anxiety symptoms respectively. After adjusting for potential confounders, our study found that the odds of antenatal depressive symptoms was about four and threefold higher among pregnant women who reported low emotional/informational support (AOR = 4.75; 95% CI: 1.45, 15.66; p = 0.010) and low social support (overall support) (AOR = 3.26; 95%CI: 1.05, 10.10, p = 0.040) respectively compared with their counterpart. In addition, the odds of antenatal anxiety symptoms was seven times higher among pregnant women who reported low affectionate support/positive social interaction (AOR = 7.43; 95%CI: 1.75, 31.55; p = 0.006).

Conclusion

A considerable proportion of pregnant Australian women had depressive symptoms and/or anxiety symptoms, which poses serious health concerns. Low emotional/informational support and low affectionate support/positive social interaction have a significant association with antenatal depressive and anxiety symptoms respectively. As such, targeted screening of expectant women for social support is essential.
Appendix
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Literature
1.
Smith MV, Shao L, Howell H, Lin H, Yonkers KA. Perinatal depression and birth outcomes in a healthy start project. Matern Child Health J. 2011;15:401–9.PubMedPubMedCentralCrossRef
2.
Wadhwa PD, Glynn L, Hobel CJ, Garite TJ, Porto M, Chicz-DeMet A, et al. Behavioral perinatology: biobehavioral processes in human fetal development. Regul Pept. 2002;108:149–57.PubMedCrossRef
3.
Dunkel Schetter C. Psychological science on pregnancy: stress processes, biopsychosocial models, and emerging research issues. Annu Rev Psychol. 2011;62:531–58.PubMedCrossRef
4.
Rich-Edwards JW, Kleinman K, Abrams A, Harlow BL, McLaughlin TJ, Joffe H, et al. Sociodemographic predictors of antenatal and postpartum depressive symptoms among women in a medical group practice. J Epidemiol Community Health. 2006;60:221–7.PubMedPubMedCentralCrossRef
5.
Kastrup MC, Ramos AB. Global mental health. Dan Med Bull. 2007;54:42–3.PubMed
6.
Bennett HA, Einarson A, Taddio A, Koren G, Einarson TR. Prevalence of depression during pregnancy: a systematic review. Obstet Gynecol. 2004;103:698–709.PubMedCrossRef
7.
Gelaye B, Rondon MB, Araya R, Williams MA. Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries. Lancet Psychiatry. 2016;3:973–82.PubMedPubMedCentralCrossRef
8.
Ogbo FA, Eastwood J, Hendry A, Jalaludin B, Agho KE, Barnett B, et al. Determinants of antenatal depression and postnatal depression in Australia. BMC Psychiatry. 2018;18:49.PubMedPubMedCentralCrossRef
9.
Buist A, Bilszta J, Milgrom J, Condon J, Speelman C, Hayes B, et al. The beyondblue National Postnatal Depression Program, Prevention and Early Intervention 2001-2005, Final Report. Hawthorn West, Vic: Beyondblue: The National Depression Initiative; 2006.
10.
Eastwood J, Ogbo F, Hendry A, Noble J, Page A. Early years research group (EYRG). The Impact of Antenatal Depression on Perinatal Outcomes in Australian Women. PLoS One. 2017;12:e0169907.PubMedPubMedCentralCrossRef
11.
12.
Huizink AC, Mulder EJ, de Medina PGR, Visser GH, Buitelaar JK. Is pregnancy anxiety a distinctive syndrome? Early Hum Dev. 2004;79:81–91.PubMedCrossRef
13.
Dennis C-L, Falah-Hassani K, Shiri R. Prevalence of antenatal and postnatal anxiety: systematic review and meta-analysis. Br J Psychiatry. 2017;210:315–23.PubMedCrossRef
14.
Serçekuş P, Okumuş H. Fears associated with childbirth among nulliparous women in Turkey. Midwifery. 2009;25:155–62.PubMedCrossRef
15.
Rico MAG, Rodríguez AJM, Díez SMU, Real MCM. Análisis de la relación entre riesgo gestacional y ansiedad materna. Progresos de Obstetricia y Ginecología. 2010;53:273–9.CrossRef
16.
Hernández-Martínez C, Val VA, Murphy M, Busquets PC, Sans JC. Relation between positive and negative maternal emotional states and obstetrical outcomes. Women & health. 2011;51:124–35.CrossRef
17.
Nieminen K, Stephansson O, Ryding EL. Women's fear of childbirth and preference for cesarean section–a cross-sectional study at various stages of pregnancy in Sweden. Acta Obstet Gynecol Scand. 2009;88:807–13.PubMedCrossRef
18.
Teixeira C, Figueiredo B, Conde A, Pacheco A, Costa R. Anxiety and depression during pregnancy in women and men. J Affect Disord. 2009;119:142–8.PubMedCrossRef
19.
Faisal-Cury A, Menezes PR. Prevalence of anxiety and depression during pregnancy in a private setting sample. Archives of women's mental health. 2007;10:25–32.PubMedCrossRef
20.
Gong X, Hao J, Tao F, Zhang J, Wang H, Xu R. Pregnancy loss and anxiety and depression during subsequent pregnancies: data from the C-ABC study. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2013;166:30–6.CrossRef
21.
Bogaerts AF, Devlieger R, Nuyts E, Witters I, Gyselaers W, Guelinckx I, et al. Anxiety and depressed mood in obese pregnant women: a prospective controlled cohort study. Obesity facts. 2013;6:152–64.PubMedPubMedCentralCrossRef
22.
Woods-Giscombé CL, Lobel M, Crandell JL. The impact of miscarriage and parity on patterns of maternal distress in pregnancy. Research in nursing & health. 2010;33:316–28.CrossRef
23.
Bayrampour H, McDonald S, Tough S. Risk factors of transient and persistent anxiety during pregnancy. Midwifery. 2015;31:582–9.PubMedCrossRef
24.
Agrati D, Browne D, Jonas W, Meaney M, Atkinson L, Steiner M, et al. Maternal anxiety from pregnancy to 2 years postpartum: transactional patterns of maternal early adversity and child temperament. Archives of women's mental health. 2015;18:693–705.PubMedCrossRef
25.
26.
Byatt N, Hicks-Courant K, Davidson A, Levesque R, Mick E, Allison J, et al. Depression and anxiety among high-risk obstetric inpatients. Gen Hosp Psychiatry. 2014;36:644–9.PubMedPubMedCentralCrossRef
27.
Fadzil A, Balakrishnan K, Razali R, Sidi H, Malapan T, Japaraj RP, et al. Risk factors for depression and anxiety among pregnant women in H ospital T uanku B ainun, I poh, M alaysia. Asia Pac Psychiatry. 2013;5:7–13.PubMedCrossRef
28.
Arch JJ. Pregnancy-specific anxiety: which women are highest and what are the alcohol-related risks? Compr Psychiatry. 2013;54:217–28.PubMedCrossRef
29.
Rubertsson C, Hellström J, Cross M, Sydsjö G. Anxiety in early pregnancy: prevalence and contributing factors. Archives of women's mental health. 2014;17:221–8.PubMedCrossRef
30.
van Heyningen T, Honikman S, Myer L, Onah MN, Field S, Tomlinson M. Prevalence and predictors of anxiety disorders amongst low-income pregnant women in urban South Africa: a cross-sectional study. Arch Womens Ment Health. 2017;20:765–75.PubMedPubMedCentralCrossRef
31.
Biaggi A, Conroy S, Pawlby S, Pariante CM. Identifying the women at risk of antenatal anxiety and depression: a systematic review. J Affect Disord. 2016;191:62–77.PubMedPubMedCentralCrossRef
32.
Edwards B, Galletly C, Semmler-Booth T, Dekker G. Antenatal psychosocial risk factors and depression among women living in socioeconomically disadvantaged suburbs in Adelaide, South Australia. Australian & New Zealand Journal of Psychiatry. 2008;42:45–50.CrossRef
33.
Bisetegn TA, Mihretie G, Muche T. Prevalence and predictors of depression among pregnant women in Debretabor town, Northwest Ethiopia. PLoS One. 2016;11:e0161108.PubMedPubMedCentralCrossRef
34.
Biratu A, Haile D. Prevalence of antenatal depression and associated factors among pregnant women in Addis Ababa, Ethiopia: a cross-sectional study. Reprod Health. 2015;12:99.PubMedPubMedCentralCrossRef
35.
Orr ST, Miller CA. Maternal depressive symptoms and the risk of poor pregnancy outcome: review of the literature and preliminary findings. Epidemiol Rev. 1995;17:165–71.PubMedCrossRef
36.
Kurki T, Hiilesmaa V, Raitasalo R, Mattila H, Ylikorkala O. Depression and anxiety in early pregnancy and risk for preeclampsia. Obstet Gynecol. 2000;95:487–90.PubMed
37.
Freeman MP. Perinatal psychiatry: risk factors, treatment data, and specific challenges for clinical researchers. The Journal of clinical psychiatry. 2008;69:633–4.PubMedCrossRef
38.
Hollins K. Consequences of antenatal mental health problems for child health and development. Curr Opin Obstet Gynecol. 2007;19:568–72.PubMedCrossRef
39.
Heron J, O'Connor TG, Evans J, Golding J, Glover V, Team AS. The course of anxiety and depression through pregnancy and the postpartum in a community sample. J Affect Disord. 2004;80:65–73.PubMedCrossRef
40.
Hart S, Field T, del Valle C, Pelaez-Nogueras M. Depressed mothers' interactions with their one-year-old infants. Infant Behav Dev. 1998;21:519–25.CrossRef
41.
Figueiredo B, Costa R, Pacheco A, Pais A. Mother-to-infant emotional involvement at birth. Matern Child Health J. 2009;13:539–49.PubMedCrossRef
42.
Da Costa D, Larouche J, Dritsa M, Brender W. Psychosocial correlates of prepartum and postpartum depressed mood. J Affect Disord. 2000;59:31–40.PubMedCrossRef
43.
Cohen MM, Ansara D, Schei B, Stuckless N, Stewart DE. Posttraumatic stress disorder after pregnancy, labor, and delivery. Journal of Women's Health. 2004;13:315–24.PubMedCrossRef
44.
Cohen S, Underwood LG, Gottlieb BH. Social support measurement and intervention: a guide for health and social scientists: Oxford University Press; 2000.CrossRef
45.
Brown WJ, Bryson L, Byles JE, Dobson AJ, Lee C, Mishra G, et al. Women's health Australia: recruitment for a national longitudinal cohort study. Women & health. 1999;28:23–40.CrossRef
46.
Loxton D, Tooth L, Harris ML, Forder PM, Dobson A, Powers J, et al. Cohort profile: the Australian longitudinal study on Women’s health (ALSWH) 1989–95 cohort. International journal of epidemiology. 2018;47:391–392e.PubMedCrossRef
47.
Lee C, Dobson AJ, Brown WJ, Bryson L, Byles J, Warner-Smith P, et al. Cohort profile: the Australian longitudinal study on women's health. Int J Epidemiol. 2005;34:987–91.PubMedCrossRef
48.
Andresen EM, Malmgren JA, Carter WB, Patrick DL. Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med. 1994;10:77–84.PubMedCrossRef
49.
Canady RB, Stommel M, Holzman C. Measurement properties of the centers for epidemiological studies depression scale (CES-D) in a sample of African American and non-Hispanic white pregnant women. J Nurs Meas. 2009;17:91–104.PubMedPubMedCentralCrossRef
50.
Mosack V, Shore ER. Screening for depression among pregnant and postpartum women. J Community Health Nurs. 2006;23:37–47.PubMedCrossRef
51.
Marcus SM, Flynn HA, Blow FC, Barry KL. Depressive symptoms among pregnant women screened in obstetrics settings. J Women's Health. 2003;12:373–80.CrossRef
52.
Holzman C, Eyster J, Tiedje LB, Roman LA, Seagull E, Rahbar MH. A life course perspective on depressive symptoms in mid-pregnancy. Matern Child Health J. 2006;10:127.PubMedCrossRef
53.
Seto M, Cornelius MD, Goldschmidt L, Morimoto K, Day NL. Long-term effects of chronic depressive symptoms among low-income childrearing mothers. Matern Child Health J. 2005;9:263–71.PubMedCrossRef
54.
55.
Leach LS, Christensen H, Mackinnon A. Pregnancy and levels of depression and anxiety: a prospective cohort study of Australian women. Australian & New Zealand Journal of Psychiatry. 2014;48:944–51.CrossRef
56.
57.
Russell A, Smith N. Medical outcomes study social support index: ALSWH data dictionary supplement. Newcastle, Australia: Australian Longitudinal Study on Women’s Health; 2002.
58.
Chojenta C, Loxton D, Lucke J. How do previous mental health, social support, and stressful life events contribute to postnatal depression in a representative sample of Australian women? J Midwifery Womens Health. 2012;57:145–50.PubMedCrossRef
59.
Department of Health and Aged Care (GISCA). Measuring remoteness: Accessibility/Remoteness Index of Australia (ARIA) Revised Ed. Canberra: Department of Health and Aged Care; 2001.
60.
Bell S, Lee C. Development of the perceived stress questionnaire for young women. Psychology, Health & Medicine. 2002;7:189–201.CrossRef
61.
Bell S, Lee C. Perceived stress revisited: the Women's health Australia project young cohort. Psychology, Health & Medicine. 2003;8:343–53.CrossRef
62.
Bell S, Lee C. Does timing and sequencing of transitions to adulthood make a difference? Stress, smoking, and physical activity among young Australian women. International journal of behavioral medicine. 2006;13:265–74.PubMedCrossRef
63.
Brussen KA. The Australian Guidelines to Reduce Health Risks from Drinking Alcohol. Chisholm Health Ethics Bulletin. 2010;15(3):9–12.
64.
WHO. Physical status: The use and interpretation of anthropometry. WHO technical report series. 1995;854(9).
65.
Hosmer DW, Lemeshow S. Applied logistic regression. New York: John Wiley & Sons; 2000.CrossRef
66.
Haneuse S, VanderWeele TJ, Arterburn D. Using the E-value to assess the potential effect of unmeasured confounding in observational studies. Jama. 2019;321:602–3.PubMedCrossRef
67.
VanderWeele TJ, Ding P. Sensitivity analysis in observational research: introducing the E-value. Ann Intern Med. 2017;167:268–74.PubMedCrossRef
68.
Linden A, Mathur MB, VanderWeele TJ. Conducting sensitivity analysis for unmeasured confounding in observational studies using E-values: the evalue package. Stata J. 2020;20:162–75.CrossRef
69.
70.
Senturk V, Abas M, Berksun O, Stewart R. Social support and antenatal depression in extended and nuclear family environments in Turkey: a cross-sectional survey. BMC Psychiatry. 2011;11:48.PubMedPubMedCentralCrossRef
71.
Dibaba Y, Fantahun M, Hindin MJ. The association of unwanted pregnancy and social support with depressive symptoms in pregnancy: evidence from rural southwestern Ethiopia. BMC pregnancy and childbirth. 2013;13:135.PubMedPubMedCentralCrossRef
72.
Rubertsson C, Waldenström U, Wickberg B. Depressive mood in early pregnancy: prevalence and women at risk in a national Swedish sample. Journal of Reproductive & Infant Psychology. 2003;21:113–23.CrossRef
73.
Spoozak L, Gotman N, Smith MV, Belanger K, Yonkers KA. Evaluation of a social support measure that may indicate risk of depression during pregnancy. J Affect Disord. 2009;114:216–23.PubMedCrossRef
74.
Pajulo M, Savonlahti E, Sourander A, Helenius H, Piha J. Antenatal depression, substance dependency and social support. J Affect Disord. 2001;65:9–17.PubMedCrossRef
75.
Tang X, Lu Z, Hu D, Zhong X. Influencing factors for prenatal stress, anxiety and depression in early pregnancy among women in Chongqing, China. J Affect Disord. 2019;253:292–302.PubMedCrossRef
76.
Abujilban SK, Abuidhail J, Al-Modallal H, Hamaideh S, Mosemli O. Predictors of antenatal depression among Jordanian pregnant women in their third trimester. Health Care Women Int. 2014;35:200–15.PubMedCrossRef
77.
Salameh T. Factors influencing postpartum depression among Jordanian women. Amman, Jordan: University of Jordan, Faculty of Nursing; 2006.
78.
Alden LE, Mellings TM. Generalized social phobia and social judgments: the salience of self-and partner-information. Journal of Anxiety Disorders. 2004;18:143–57.PubMedCrossRef
79.
Gourounti K, Anagnostopoulos F, Lykeridou K. Coping strategies as psychological risk factor for antenatal anxiety, worries, and depression among Greek women. Arch Womens Ment Health. 2013;16:353–61.PubMedCrossRef
80.
Dunkel Schetter C, Niles AN, Guardino CM, Khaled M, Kramer MS. Demographic, medical, and psychosocial predictors of pregnancy anxiety. Paediatric & Perinatal Epidemiology. 2016;30:421–9.CrossRef
81.
Cheng ER, Rifas-Shiman SL, Perkins ME, Rich-Edwards JW, Gillman MW, Wright R, et al. The influence of antenatal partner support on pregnancy outcomes. J Women's Health (Larchmt). 2016;25:672–9.CrossRef
82.
Gao L, Qu J, Wang AY. Anxiety, depression and social support in pregnant women with a history of recurrent miscarriage: a cross-sectional study. J Reprod Infant Psychol. 2020;38(5):497–508.
83.
Martini J, Petzoldt J, Einsle F, Beesdo-Baum K, Hofler M, Wittchen HU. Risk factors and course patterns of anxiety and depressive disorders during pregnancy and after delivery: a prospective-longitudinal study. J Affect Disord. 2015;175:385–95.PubMedCrossRef
84.
Pottinger AM, Trotman-Edwards H, Younger N. Detecting depression during pregnancy and associated lifestyle practices and concerns among women in a hospital-based obstetric clinic in Jamaica. Gen Hosp Psychiatry. 2009;31:254–61.PubMedCrossRef
85.
Thompson O, Ajayi I. Prevalence of Antenatal Depression and Associated Risk Factors among Pregnant Women Attending Antenatal Clinics in Abeokuta North Local Government Area, Nigeria. Depress Res Treat. 2016;2016:4518979. https://​doi.​org/​10.​1155/​2016/​4518979. Epub 2016 Aug 18.
86.
Melo EF Jr, Cecatti JG, Pacagnella RC, Leite DF, Vulcani DE, Makuch MY. The prevalence of perinatal depression and its associated factors in two different settings in Brazil. J Affect Disord. 2012;136:1204–8.PubMedCrossRef
87.
Fisher J, Tran T, Tran TD, Dwyer T, Nguyen T, Casey GJ, et al. Prevalence and risk factors for symptoms of common mental disorders in early and late pregnancy in Vietnamese women: a prospective population-based study. J Affect Disord. 2013;146:213–9.PubMedCrossRef
88.
van Heyningen T, Myer L, Onah M, Tomlinson M, Field S, Honikman S. Antenatal depression and adversity in urban South Africa. J Affect Disord. 2016;203:121–9.PubMedPubMedCentralCrossRef
89.
Kaida A, Matthews LT, Ashaba S, Tsai AC, Kanters S, Robak M, et al. Depression during pregnancy and the postpartum among HIV-infected women on antiretroviral therapy in Uganda. Journal of acquired immune deficiency syndromes (1999). 2014;67:S179.CrossRef
90.
Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988;56:893.PubMedCrossRef
Metadata
Title
The association between social support and antenatal depressive and anxiety symptoms among Australian women
Authors
Asres Bedaso
Jon Adams
Wenbo Peng
David Sibbritt
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2021
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-021-04188-4

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