Anxiety and Coping Strategies in the Perinatal Period
Anxiety and Coping Strategies in the Perinatal Period
Recruited women were between 19 to 46 years of age with a mean age of 29.2 ± 4.7 years. The majority of women were primiparous (83.5%), lived with the child's father (92.5%) and had a planned pregnancy (78.2%). Difficulties in getting pregnant were reported by 30.8% of the women while 27.7% indicated complications during pregnancy. Our postnatal population did not differ from the prenatal sample according to mean age (29.1 years, SD 4.9), primiparous (84.5%), living with the baby's father (95.2%), difficulties in getting pregnant (29.9%) or complications during birth (25.6%). Before birth, these characteristics did not differ between the three aforementioned anxiety groups (p from 0.28 to 0.92). Apparent differences in anxiety observed among the three groups were not attributable to differences in these categories. After birth, there was also no significant relationship, aside from a tendency for age: younger women appeared to be more anxious after birth, although the difference was not statistically significant (p = 0.10). In addition, we analysed differences between responders and non-responders within these categories as well as their anxiety score: there was no significant differences between women responding after birth and non-responders.
At the prenatal phase, 18.5% (n = 74/400) of pregnant women presented severe anxiety symptoms while 24.5% (n = 98/400) presented moderate anxiety symptoms. At the postnatal phase, anxiety prevalence was higher with 20.2% (35/173) of women presenting severe anxiety symptoms and 24.3% (N = 42/173) moderate anxiety symptoms. The relationship between anxiety before and anxiety after giving birth was relatively high (Kappa coefficient = 0.46): 59.3% of the women who were anxious at the prenatal phase remained anxious after birth.
Firstly, results show time effects regarding the use of coping strategies before and after giving birth: nearly all coping strategies declined at 2 months postpartum, except for substance use, which increased significantly (p = 0.023), and for humour and behavioural disengagement, which showed no significant differences in pre- and postnatal population (see Table 1).
Secondly, regarding group effects, in the last trimester of pregnancy, the women presenting severe anxiety symptoms used coping strategies significantly less often with adaptive values such as acceptance (p = 0.016), positive reframing (p = 0.025) and humour (p = 0.04) than women presenting moderate or no anxiety (see Table 1). Additionally, the higher the level of anxiety, the more likely the women used problematic coping responses such as denial (p = 0.05) and self-blame (p = 0.001).
At the postpartum phase, severe anxiety was associated with the self-blame strategy of coping (p ≤0.05) and women with severe anxiety were more likely to use denial (p ≤0.05). Moreover, two months after birth, women with severe anxiety had significantly more difficulties in positive reframing of their new situation than women presenting no anxiety.
Lastly, results showed no interaction effect between time and group effect.
Results
Sample Characteristics
Recruited women were between 19 to 46 years of age with a mean age of 29.2 ± 4.7 years. The majority of women were primiparous (83.5%), lived with the child's father (92.5%) and had a planned pregnancy (78.2%). Difficulties in getting pregnant were reported by 30.8% of the women while 27.7% indicated complications during pregnancy. Our postnatal population did not differ from the prenatal sample according to mean age (29.1 years, SD 4.9), primiparous (84.5%), living with the baby's father (95.2%), difficulties in getting pregnant (29.9%) or complications during birth (25.6%). Before birth, these characteristics did not differ between the three aforementioned anxiety groups (p from 0.28 to 0.92). Apparent differences in anxiety observed among the three groups were not attributable to differences in these categories. After birth, there was also no significant relationship, aside from a tendency for age: younger women appeared to be more anxious after birth, although the difference was not statistically significant (p = 0.10). In addition, we analysed differences between responders and non-responders within these categories as well as their anxiety score: there was no significant differences between women responding after birth and non-responders.
Prevalence of Prenatal and Postnatal Anxiety
At the prenatal phase, 18.5% (n = 74/400) of pregnant women presented severe anxiety symptoms while 24.5% (n = 98/400) presented moderate anxiety symptoms. At the postnatal phase, anxiety prevalence was higher with 20.2% (35/173) of women presenting severe anxiety symptoms and 24.3% (N = 42/173) moderate anxiety symptoms. The relationship between anxiety before and anxiety after giving birth was relatively high (Kappa coefficient = 0.46): 59.3% of the women who were anxious at the prenatal phase remained anxious after birth.
Firstly, results show time effects regarding the use of coping strategies before and after giving birth: nearly all coping strategies declined at 2 months postpartum, except for substance use, which increased significantly (p = 0.023), and for humour and behavioural disengagement, which showed no significant differences in pre- and postnatal population (see Table 1).
Secondly, regarding group effects, in the last trimester of pregnancy, the women presenting severe anxiety symptoms used coping strategies significantly less often with adaptive values such as acceptance (p = 0.016), positive reframing (p = 0.025) and humour (p = 0.04) than women presenting moderate or no anxiety (see Table 1). Additionally, the higher the level of anxiety, the more likely the women used problematic coping responses such as denial (p = 0.05) and self-blame (p = 0.001).
At the postpartum phase, severe anxiety was associated with the self-blame strategy of coping (p ≤0.05) and women with severe anxiety were more likely to use denial (p ≤0.05). Moreover, two months after birth, women with severe anxiety had significantly more difficulties in positive reframing of their new situation than women presenting no anxiety.
Lastly, results showed no interaction effect between time and group effect.
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