The comorbidity of anxiety and depression symptoms during pregnancy trimesters

Abstract

Objectives. The scientific aim of this work was the assessment of anxiety and depressive symptoms in particular pregnancy trimesters and the analysis of different types of anxiety: anxiety as a state and anxiety as a trait.

Material and methods. The research was conducted in gynecologic-obstetric clinics in the area of Lublin and Mazovian provinces from January 2011 to May 2012. It was longitudinal prospective trial. Each woman was examined three times: during first, second and third trimester. The following measurements were used in this work: Demographic and epidemiologic questionnaire – of own construction, Hospital Anxiety and Depression Scale (HADS), State and Trait of Anxiety Inventory. At visits in clinic during consecutive trimesters, women were given a set of questionnaires for filling in and they returned them at next visit. The examined group consisted of 314 pregnant adult (over 18 years old) women.

The results were statistically analyzed. Basic parameters of descriptive statistics were determined: arithmetical means, standard deviation, median, minimal and maximal value. Due to other than normal distribution of the examined variables – the following nonparametric tests were used: U Mann-Whitney test and ANOVA of Kruskal-Wallis. The analysis of mutual correlation between examined parameters was performed using the Spearman range correlation test. Five percent inference error was assumed and correlated level of significance p(α)<0.05.  

Results. Anxiety symptoms in the first trimester of pregnancy were experienced by 27.4% of respondents, in the second trimester – by 23.9%, in the third – by 29.9%. Depressive symptoms occurred less frequently, and so: in the first trimester in 15.3% of subjects, in the second in 12.7%, in the third- in 14% of the studied the women. At least once the symptoms of anxiety were experienced by 37.9% of the respondents, depressive symptoms - by 25.48%. Percentages of the women, in whom anxiety and depressive symptoms coexisted in different trimesters, amounted to 12.7% of the respondents in the first, 10.8% in the second and 12.4% in the third trimester of pregnancy. Anxiety symptoms were present in 15.9% of patients in all trimesters of pregnancy, and in 11.5% in the two trimesters. For depression, these percentages were respectively 3.5% and 9.6%. The relation between the severity of symptoms of anxiety and depression severity in different trimesters was confirmed, but this relationship was stronger in the first and third trimester than in the second trimester. Both scales (anxiety as a state and as a trait) of the Inventory of State and Trait Anxiety correlated with the severity of symptoms of hospital anxiety and depression scale (HADS). Anxiety as a state most strongly correlated with symptoms of anxiety in the third trimester and with depression in the first trimester. Anxiety as a trait most strongly correlated with symptoms of anxiety and depression in the third trimester.

Conclusions. Introducing of screening tests regarding anxiety and depression during pregnancy, conducted systematically during this period, creates possibility for earlier diagnosis and quicker provision of appropriate interventions. Earlier diagnosis and appropriate interventions in case of anxiety and depression development during pregnancy creates a possibility of preventing their effects, such as postpartum depression and disturbed psychophysical development of child.