TY - JOUR
T1 - Longitudinal course of ante- and postpartum generalized anxiety symptoms and associated factors in West-African women from Ghana and ZAF
AU - Barthel, Dana
AU - Kriston, Levente
AU - Barkmann, Claus
AU - Appiah-Poku, John
AU - Te Bonle, Marguerite
AU - Esther Doris, Kra Yao
AU - Carine Esther, Bony Kotchi
AU - Jean Armel, Koffi Ekissi
AU - Mohammed, Yasmin
AU - Osei, Yaw
AU - Fordjour, Daniel
AU - Owusu, Dorcas
AU - Eberhardt, Kirsten A.
AU - Hinz, Rebecca
AU - Koffi, Mathurin
AU - N'Goran, Eliezer
AU - Nguah, Samuel Blay
AU - Tagbor, Harry
AU - Schoppen, Stefanie
AU - Ehrhardt, Stephan
AU - Bindt, Carola
N1 - Publisher Copyright:
© 2016 Elsevier B.V. All rights reserved.
PY - 2016/6/1
Y1 - 2016/6/1
N2 - Background Little is known about the course of perinatal anxiety, particularly in low and middle income countries. This study aimed at examining trajectories of ante- and postpartum generalized anxiety symptoms in West-African women and their associations with mother and child characteristics. Methods 778 women from ZAF and Ghana were investigated between 04/2010 and 03/2014. Anxiety symptoms were measured using the seven-item Generalized Anxiety Disorder scale (GAD-7) at three months antepartum and three, 12 and 24 months postpartum. Growth mixture modeling was applied to identify latent trajectory classes of anxiety. Multinomial logistic regression was used to investigate the associations of psychosocial, sociodemographic, obstetric and clinical characteristics with different trajectories. Results Four distinct trajectories of anxiety were identified. The majority of women (79.8%) had consistent low anxiety symptoms, while 11.4% had elevated anxiety scores before and around childbirth that decreased gradually. 5.4% of women showed increasing anxiety symptoms over time. Few women (3.3%) had transient anxiety with elevated scores at three and 12 months postpartum. Risk factors for elevated anxiety levels around childbirth were antepartum depressive symptoms, higher levels of stress (economic, marital and social stress), lower child birth weight, and multiparity. Partner support was found to be protective. Limitations Anxiety symptoms were assessed using a screening instrument and not through a formal diagnostic classification system. Some putative risk factors were not investigated, and some psychosocial factors were assessed retrospectively. Conclusion The presence of different trajectories underline the importance of monitoring anxiety symptoms in pregnant women and in mothers with infants/toddlers.
AB - Background Little is known about the course of perinatal anxiety, particularly in low and middle income countries. This study aimed at examining trajectories of ante- and postpartum generalized anxiety symptoms in West-African women and their associations with mother and child characteristics. Methods 778 women from ZAF and Ghana were investigated between 04/2010 and 03/2014. Anxiety symptoms were measured using the seven-item Generalized Anxiety Disorder scale (GAD-7) at three months antepartum and three, 12 and 24 months postpartum. Growth mixture modeling was applied to identify latent trajectory classes of anxiety. Multinomial logistic regression was used to investigate the associations of psychosocial, sociodemographic, obstetric and clinical characteristics with different trajectories. Results Four distinct trajectories of anxiety were identified. The majority of women (79.8%) had consistent low anxiety symptoms, while 11.4% had elevated anxiety scores before and around childbirth that decreased gradually. 5.4% of women showed increasing anxiety symptoms over time. Few women (3.3%) had transient anxiety with elevated scores at three and 12 months postpartum. Risk factors for elevated anxiety levels around childbirth were antepartum depressive symptoms, higher levels of stress (economic, marital and social stress), lower child birth weight, and multiparity. Partner support was found to be protective. Limitations Anxiety symptoms were assessed using a screening instrument and not through a formal diagnostic classification system. Some putative risk factors were not investigated, and some psychosocial factors were assessed retrospectively. Conclusion The presence of different trajectories underline the importance of monitoring anxiety symptoms in pregnant women and in mothers with infants/toddlers.
KW - Ante- and postpartum
KW - Childbirth
KW - Generalized anxiety disorder
KW - Latent class models
KW - Longitudinal study
KW - Maternal health
KW - Pregnancy
KW - Sub-Saharan Africa
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U2 - 10.1016/j.jad.2016.03.014
DO - 10.1016/j.jad.2016.03.014
M3 - Article
C2 - 26991367
AN - SCOPUS:84960893906
SN - 0165-0327
VL - 197
SP - 125
EP - 133
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -