Skip to main content
Top
Published in: BMC Pregnancy and Childbirth 1/2013

Open Access 01-12-2013 | Research article

Anxiety symptoms and coping strategies in the perinatal period

Authors: Astrid George, Rita F Luz, Claude De Tychey, Nathalie Thilly, Elisabeth Spitz

Published in: BMC Pregnancy and Childbirth | Issue 1/2013

Login to get access

Abstract

Background

The aim of the present study was to explore the prospective relationship between anxiety symptoms and coping strategies during late pregnancy and early postpartum.

Methods

Participants completed the Hospital Anxiety Depression-Anxiety subscale and Carver’s Brief COPE at two time points, namely during the last trimester of pregnancy (N = 400) and at two months postpartum (N = 158).

Results

Antenatally, 18.8% of pregnant women presented severe anxiety symptoms while 20.2% of women presented severe anxiety symptoms after birth. Carver's proposed coping styles allowed to significantly distinguish between anxious and non anxious women during these two periods. Anxious women used significantly more inappropriate coping and less adaptive coping responses, such as self-blame and denial of reality, which remained associated with anxiety in the perinatal period. Our results also indicated a decrease in adaptive coping in women without anxiety after birth (e.g. acceptance, positive reframing).

Conclusion

Our findings confirm that antenatal and postnatal anxiety symptoms occur frequently and that inappropriate and/or non functional coping may account for persisting anxiety after childbirth. Limitations: Data were based on self-reports and participating women were predominantly primiparous. A high drop-out rate at two months postpartum must also be acknowledged.
Literature
1.
go back to reference Brockington IF, Macdonald E: Anxiety, obsessions and morbid preoccupations in pregnancy and the puerperium. Arch Womens Ment Health. 2006, 9 (5): 253-263. 10.1007/s00737-006-0134-z.CrossRefPubMed Brockington IF, Macdonald E: Anxiety, obsessions and morbid preoccupations in pregnancy and the puerperium. Arch Womens Ment Health. 2006, 9 (5): 253-263. 10.1007/s00737-006-0134-z.CrossRefPubMed
2.
go back to reference Wenzel A, Haugen EN, Jackson LC, Brendle JR: Anxiety symptoms and disorders at eight weeks postpartum. J Anx Disord. 2005, 19 (3): 295-311. 10.1016/j.janxdis.2004.04.001.CrossRef Wenzel A, Haugen EN, Jackson LC, Brendle JR: Anxiety symptoms and disorders at eight weeks postpartum. J Anx Disord. 2005, 19 (3): 295-311. 10.1016/j.janxdis.2004.04.001.CrossRef
3.
go back to reference Hofberg K, Brockington I, Tokophobia : An unreasoning dread of childbirth. A series of 26 cases. Br J Psychiatry. 2000, 176: 83-85. 10.1192/bjp.176.1.83.CrossRefPubMed Hofberg K, Brockington I, Tokophobia : An unreasoning dread of childbirth. A series of 26 cases. Br J Psychiatry. 2000, 176: 83-85. 10.1192/bjp.176.1.83.CrossRefPubMed
4.
go back to reference Huizink AC, Mulder EJH, de Medina PG R, Visser GH, Buitelaar JK: "Is pregnancy anxiety a distinctive syndrome?". Early Hum Dev. 2004, 79 (2): 81-91. 10.1016/j.earlhumdev.2004.04.014.CrossRefPubMed Huizink AC, Mulder EJH, de Medina PG R, Visser GH, Buitelaar JK: "Is pregnancy anxiety a distinctive syndrome?". Early Hum Dev. 2004, 79 (2): 81-91. 10.1016/j.earlhumdev.2004.04.014.CrossRefPubMed
5.
go back to reference Meades R, Ayers S: Anxiety measures validated in perinatal populations: a systematic review. J Affect Disord. 2011, 133 (1–2): 1-15.CrossRefPubMed Meades R, Ayers S: Anxiety measures validated in perinatal populations: a systematic review. J Affect Disord. 2011, 133 (1–2): 1-15.CrossRefPubMed
6.
go back to reference Hall WA, Stoll K, Hutton EK, Brown H: A prospective study of effects of psychological factors and sleep on obstetric intervention, mode of birth, and neonatal outcomes among low-risk British Columbian women. BMC Pregnancy Childbirth. 2012, 3: 12-78. Hall WA, Stoll K, Hutton EK, Brown H: A prospective study of effects of psychological factors and sleep on obstetric intervention, mode of birth, and neonatal outcomes among low-risk British Columbian women. BMC Pregnancy Childbirth. 2012, 3: 12-78.
7.
go back to reference Skouteris H, Wertheim EH, Rallis S, Milgrom J, Paxton SJ: Depression and anxiety through pregnancy and the early postpartum: an examination of prospective relationships. J Affect Disord. 2009, 113 (3): 303-8. 10.1016/j.jad.2008.06.002.CrossRefPubMed Skouteris H, Wertheim EH, Rallis S, Milgrom J, Paxton SJ: Depression and anxiety through pregnancy and the early postpartum: an examination of prospective relationships. J Affect Disord. 2009, 113 (3): 303-8. 10.1016/j.jad.2008.06.002.CrossRefPubMed
8.
go back to reference Jomeen J, Martin CR: Is the Hospital Anxiety and Depression Scale (HADS) a reliable screening tool in early pregnancy?. Psychol Health. 2005, 19: 787-800.CrossRef Jomeen J, Martin CR: Is the Hospital Anxiety and Depression Scale (HADS) a reliable screening tool in early pregnancy?. Psychol Health. 2005, 19: 787-800.CrossRef
9.
go back to reference Huizink AC, de Medina PG R, Mulder EJ, Visser GH, Buitelaar JK: Stress during pregnancy is associated with developmental outcome in infancy. J Child Psychol Psychiatry. 2003, 44 (6): 810-818. 10.1111/1469-7610.00166.CrossRefPubMed Huizink AC, de Medina PG R, Mulder EJ, Visser GH, Buitelaar JK: Stress during pregnancy is associated with developmental outcome in infancy. J Child Psychol Psychiatry. 2003, 44 (6): 810-818. 10.1111/1469-7610.00166.CrossRefPubMed
10.
go back to reference O'Connor TG, Heron J, Golding J, Beveridge M, Glover V: Maternal antenatal anxiety and children's behavioural/emotional problems at 4 years. Report from the Avon Longitudinal Study of Parents and Children. Br J Psychiatry. 2002, 180: 502-508. 10.1192/bjp.180.6.502.CrossRefPubMed O'Connor TG, Heron J, Golding J, Beveridge M, Glover V: Maternal antenatal anxiety and children's behavioural/emotional problems at 4 years. Report from the Avon Longitudinal Study of Parents and Children. Br J Psychiatry. 2002, 180: 502-508. 10.1192/bjp.180.6.502.CrossRefPubMed
11.
go back to reference Rondó PH, Ferreira RF, Nogueira F, Ribeiro MC, Lobert H, Artes R: Maternal psychological stress and distress as predictors of low birth weight, prematurity and intrauterine growth retardation. Eur J Clin Nutr. 2003, 7 (2): 266-272.CrossRef Rondó PH, Ferreira RF, Nogueira F, Ribeiro MC, Lobert H, Artes R: Maternal psychological stress and distress as predictors of low birth weight, prematurity and intrauterine growth retardation. Eur J Clin Nutr. 2003, 7 (2): 266-272.CrossRef
12.
go back to reference Field T, Hernandez-Reif M, Figueiredo B, Deeds O, Ascencio A, Schanberg S, Kuhn C: Comorbid depression and anxiety effects on pregnancy and neonatal outcome. Infant Behav Dev. 2010, 33 (1): 23-29. 10.1016/j.infbeh.2009.10.004.CrossRefPubMed Field T, Hernandez-Reif M, Figueiredo B, Deeds O, Ascencio A, Schanberg S, Kuhn C: Comorbid depression and anxiety effects on pregnancy and neonatal outcome. Infant Behav Dev. 2010, 33 (1): 23-29. 10.1016/j.infbeh.2009.10.004.CrossRefPubMed
13.
go back to reference Zelkowitz P, Papageorgiou A: Maternal anxiety: an emerging prognostic factor in neonatology. Acta Paediatr. 2005, 94 (12): 1704-1705. 10.1080/08035250500355030.CrossRefPubMed Zelkowitz P, Papageorgiou A: Maternal anxiety: an emerging prognostic factor in neonatology. Acta Paediatr. 2005, 94 (12): 1704-1705. 10.1080/08035250500355030.CrossRefPubMed
14.
go back to reference Lazarus RS, Folkman S: Stress, Appraisal and Coping. 1984, New York: Springer Lazarus RS, Folkman S: Stress, Appraisal and Coping. 1984, New York: Springer
15.
go back to reference Deave T, Johnson D, Ingram J: Transition to parenthood: the needs of parents in pregnancy and early parenthood. BMC Pregnancy Childbirth. 2008, 8: 30-10.1186/1471-2393-8-30.CrossRefPubMedPubMedCentral Deave T, Johnson D, Ingram J: Transition to parenthood: the needs of parents in pregnancy and early parenthood. BMC Pregnancy Childbirth. 2008, 8: 30-10.1186/1471-2393-8-30.CrossRefPubMedPubMedCentral
16.
go back to reference Zigmond AS, Snaith RP: The Hospital Anxiety And Depression Scale. Acta Psychiatr Scand. 1983, 67: 361-370. 10.1111/j.1600-0447.1983.tb09716.x.CrossRefPubMed Zigmond AS, Snaith RP: The Hospital Anxiety And Depression Scale. Acta Psychiatr Scand. 1983, 67: 361-370. 10.1111/j.1600-0447.1983.tb09716.x.CrossRefPubMed
17.
go back to reference Snaith RP: The Hospital Anxiety And Depression Scale. Health Qual Life Outcomes. 2003, 1: 1-29. 10.1186/1477-7525-1-1.CrossRef Snaith RP: The Hospital Anxiety And Depression Scale. Health Qual Life Outcomes. 2003, 1: 1-29. 10.1186/1477-7525-1-1.CrossRef
18.
go back to reference Bjelland I, Dahl AA, Haug TT, Neckelmann D: The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res. 2002, 52 (2): 69-77. 10.1016/S0022-3999(01)00296-3.CrossRefPubMed Bjelland I, Dahl AA, Haug TT, Neckelmann D: The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res. 2002, 52 (2): 69-77. 10.1016/S0022-3999(01)00296-3.CrossRefPubMed
19.
go back to reference Carver CS: You want to measure coping but protocol’s too long: consider the Brief COPE. Intern J Behav Med. 1997, 41: 92-100.CrossRef Carver CS: You want to measure coping but protocol’s too long: consider the Brief COPE. Intern J Behav Med. 1997, 41: 92-100.CrossRef
20.
go back to reference Muller L, Spitz E: Evauation multidimensionnelle du coping: validation du Brief Cope sur une population française. L’Encéphale. 2003, 6: 506-518. Muller L, Spitz E: Evauation multidimensionnelle du coping: validation du Brief Cope sur une population française. L’Encéphale. 2003, 6: 506-518.
21.
go back to reference De Tychey C, Spitz E, Briançon S, Lighezzolo J, Girvan F, Rosati A, Thockler A, Vincent S: Pre- and postnatal depression and coping: a comparative approach. J Affect Disord. 2005, 85 (3): 323-326. 10.1016/j.jad.2004.11.004.CrossRefPubMed De Tychey C, Spitz E, Briançon S, Lighezzolo J, Girvan F, Rosati A, Thockler A, Vincent S: Pre- and postnatal depression and coping: a comparative approach. J Affect Disord. 2005, 85 (3): 323-326. 10.1016/j.jad.2004.11.004.CrossRefPubMed
22.
go back to reference Geisinger KF: Cross-cultural normative assessment: translation and adaption issues influencing the normative interpretation of assessment instruments. Psychol Assess. 1994, 6: 304-312.CrossRef Geisinger KF: Cross-cultural normative assessment: translation and adaption issues influencing the normative interpretation of assessment instruments. Psychol Assess. 1994, 6: 304-312.CrossRef
23.
go back to reference Heron J, O'Connor TG, Evans J, Golding J, Glover V: The course of anxiety and depression through pregnancy and the postpartum in a community sample. J Affect Disord. 2004, 80 (1): 65-73. 10.1016/j.jad.2003.08.004.CrossRefPubMed Heron J, O'Connor TG, Evans J, Golding J, Glover V: The course of anxiety and depression through pregnancy and the postpartum in a community sample. J Affect Disord. 2004, 80 (1): 65-73. 10.1016/j.jad.2003.08.004.CrossRefPubMed
24.
go back to reference Van-Bussel JC, Spitz H, Demyttenaere B: Anxiety in pregnant and postpartum women. An exploratory study of the role of maternal orientations. J Affect Disord. 2009, 11: 232-242.CrossRef Van-Bussel JC, Spitz H, Demyttenaere B: Anxiety in pregnant and postpartum women. An exploratory study of the role of maternal orientations. J Affect Disord. 2009, 11: 232-242.CrossRef
25.
go back to reference Martini J, Knappe S, Beesdo-Baum K, Lieb R, Wittchen HU: Anxiety disorders before birth and self-perceived sistress during pregnancy: Associations with maternal depression and obstetric, neonatal and early childhood outcomes. Early Hum Dev. 2010, 86: 305-310. 10.1016/j.earlhumdev.2010.04.004.CrossRefPubMed Martini J, Knappe S, Beesdo-Baum K, Lieb R, Wittchen HU: Anxiety disorders before birth and self-perceived sistress during pregnancy: Associations with maternal depression and obstetric, neonatal and early childhood outcomes. Early Hum Dev. 2010, 86: 305-310. 10.1016/j.earlhumdev.2010.04.004.CrossRefPubMed
Metadata
Title
Anxiety symptoms and coping strategies in the perinatal period
Authors
Astrid George
Rita F Luz
Claude De Tychey
Nathalie Thilly
Elisabeth Spitz
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2013
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/1471-2393-13-233

Other articles of this Issue 1/2013

BMC Pregnancy and Childbirth 1/2013 Go to the issue