Trajectories and Predictors of Perinatalanxiety Symptoms in Low-Income Ruralarea Mothers at Risk of Anxiety

Abstract

AIM: The goal of the study was to determine the trajectories of perinatal anxiety symptoms and their determinants among women who report with risk anxiety during pregnancy and live in a low-resource context in Sriperumbuthur, Chennai. Study Design: A Cross sectional study design METHADOLOGY: This cross-sectional study included 192 women from Sriperumbuthur, a low-income neighborhood in Chennai, who were selected at their rst prenatal visit if they scored 13 or higher on the Edinburgh Postnatal Anxiety Scale, were at least 18 years old, and were fewer than 29 weeks pregnant. Participants were followed up on at eight months gestation, three months postpartum, and twelve months postpartum. Growth mixture modelling was used to nd latent trajectories of anxiety symptoms based on the Hamilton Anxiety Scale (HAS). Because HAS scores did not differ between the control and intervention groups, all individuals were evaluated jointly. Using health, social, and economic variables of trajectories were studied to identify high-risk groups with more or more chronic rage symptoms. RESULTS:There were two trajectories identied: prenatal alone (88%) with moderate to severe symptoms at baseline that subsequently diminish; and antenatal and postnatal (12%) with severe anxiety symptoms during pregnancy and later in the postpartum period that subside to moderate levels at 3 months postpartum. Severe food hardship, intimate partner violence, reduced social support, more functional impairment, problematic drinking, and suicide risk are all predictors for the prenatal and postnatal trajectory. CONCLUSION: A small percentage of women who are at risk for anxiety prenatally remain at risk during pregnancy and can be distinguished from those who experience a spontaneous remission. These ndings should be included into identication and referral efforts, especially considering the scarcity of mental health services in low-income areas.