Trajectories of Depressive Symptoms and Anxiety during Pregnancy and Associations with Pregnancy Stress
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Measures
2.2.1. Depressive Symptoms
2.2.2. Anxiety
2.2.3. Pregnancy Stress
2.2.4. Cortisol Level
2.2.5. Demographic Information
2.3. Statistical Analysis
3. Results
3.1. Characteristics of Participants
3.2. Correlation between Depressive Symptoms, Anxiety, and Pregnancy Stress in Each Trimester
3.3. Description of Trajectory Group Patterns
3.3.1. Sociodemographic Characteristics by Latent Trajectory Groups of Depressive Symptoms and Anxiety
3.3.2. Factors Associated with Trajectory Groups of Depressive Symptoms and Anxiety
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | n (%) | Mean (SD) | Min.–Max. | |
---|---|---|---|---|
Age (years) | <35 | 93 (68.4) | 25–43 | |
≥35 | 43 (31.6) | |||
Education | ≤High school | 13 (9.6) | ||
College | 98 (72.1) | |||
Graduate | 25 (18.4) | |||
Employment | No | 45 (36.3) | ||
Yes | 79 (63.7) | |||
Household Income | Very Low | 5 (4.2) | ||
Low | 45 (37.8) | |||
Middle | 53 (44.5) | |||
High | 16 (13.5) | |||
Planned Pregnancy | No | 61 (45.2) | ||
Yes | 74 (54.8) | |||
Pre-Pregnancy Smoking | No | 122 (99.2) | ||
Yes | 1 (0.8) | |||
Pre-Pregnancy Drinking | No | 111 (90.2) | ||
Yes | 12 (9.8) | |||
Pre-Pregnancy Regular exercise | No | 100 (82.6) | ||
Yes | 21 (17.4) | |||
Pre-Pregnancy BMI | Underweight | 25 (18.5) | ||
Healthy weight | 80 (59.3) | |||
Overweight | 16 (11.9) | |||
Obese | 14 (10.4) | |||
Pregnancy Stress | Trimester 1 | 50.71 (10.7) | 28–79 | |
Trimester 2 | 68.48 (9.0) | 48–87 | ||
Trimester 3 | 69.02 (9.5) | 44–90 | ||
Cortisol Levels | Trimester 1 | 4.44 (4.2) | 0.1–25.6 | |
Trimester 2 | 6.23 (6.3) | 0.6–49.4 | ||
Trimester 3 | 7.57 (6.6) | 0.3–37.6 |
Trimester | Variable | 1 | 2 | 3 | |||
---|---|---|---|---|---|---|---|
Depressive Symptoms | Anxiety | Depressive Symptoms | Anxiety | Depressive Symptoms | Anxiety | ||
1 | Anxiety | 0.667 ** | |||||
Stress | 0.485 ** | 0.480 ** | |||||
2 | Anxiety | 0.750 ** | |||||
Stress | 0.479 ** | 0.461 ** | |||||
3 | Anxiety | 0.707 ** | |||||
Stress | 0.516 ** | 0.606 ** |
Variable | Group | Depressive Symptoms Trajectory Groups | Anxiety Trajectory Groups | |||||||
---|---|---|---|---|---|---|---|---|---|---|
1 | 2 | 3 | p | 1 | 2 | 3 | 4 | p | ||
(n = 96) | (n = 34) | (n = 6) | (n = 14) | (n = 91) | (n = 25) | (n = 6) | ||||
Age (year) | <35 | 64 (66.7) | 26 (76.5) | 3 (50.0) | 0.339 | 9 (64.3) | 61 (67.0) | 18 (72.0) | 5 (83.3) | 0.872 |
≥35 | 32 (33.3) | 8 (23.5) | 3 (50.0) | 5 (35.7) | 30 (33.0) | 7 (28.0) | 1 (16.7) | |||
Education | ≤High school | 9 (9.4) | 4 (11.8) | 0 (0) | 0.779 | 1 (7.1) | 10 (11.0) | 1 (4.0) | 1 (16.7) | 0.890 |
College | 67 (69.8) | 26 (76.5) | 5 (83.3) | 11 (78.6) | 65 (71.4) | 18 (72.0) | 4 (66.7) | |||
Graduate | 20 (20.8) | 4 (11.8) | 1 (16.7) | 2 (14.3) | 16 (17.6) | 6 (24.0) | 1 (16.7) | |||
Employment | No | 32 (37.2) | 10 (31.3) | 3 (50.0) | 0.675 | 3 (25.0) | 34 (40.0) | 5 (23.8) | 3 (50.0) | 0.391 |
Yes | 54 (62.8) | 22 (68.7) | 3 (50.0) | 9 (75.0) | 51 (60.0) | 16 (76.2) | 3 (50.0) | |||
Household income | Very low | 4 (4.7) | 1 (3.6) | 0 (0) | 0.913 | 0 (0) | 4 (4.9) | 1 (5.0) | 0 (0) | 0.883 |
Low | 30 (35.3) | 11 (39.3) | 4 (66.7) | 6 (50.0) | 30 (37.0) | 6 (30.0) | 3 (50.0) | |||
Middle | 39 (45.9) | 12 (42.9) | 2 (33.3) | 6 (50.0) | 36 (44.4) | 9 (45.0) | 2 (33.3) | |||
High | 12 (14.1) | 4 (14.3) | 0 (0) | 0 (0) | 11 (13.6) | 4 (20.0) | 1 (16.7) | |||
Planned pregnancy | No | 39 (41.1) | 17 (50.0) | 5 (83.3) | 0.110 | 6 (42.9) | 43 (47.3) | 9 (37.5) | 3 (50.0) | 0.844 |
Yes | 56 (58.9) | 17 (50.0) | 1 (16.7) | 8 (57.1) | 48 (52.7) | 15 (62.5) | 3 (50.0) | |||
Regular exercise | No | 71 (82.6) | 25 (86.2) | 4 (66.7) | 0.420 | 12 (100) | 66 (80.5) | 18 (85.7) | 4 (66.7) | 0.241 |
Yes | 15 (17.4) | 4 (13.8) | 2 (33.3) | 0 (0) | 16 (19.5) | 3 (14.3) | 2 (33.3) | |||
Pre-pregnancy BMI | <18.5 | 18 (18.9) | 6 (17.6) | 1 (16.7) | 0.847 | 3 (21.4) | 15 (16.5) | 5 (20.8) | 2 (33.3) | 0.798 |
18.5–23 | 58 (61.1) | 18 (52.9) | 4 (66.7) | 9 (64.3) | 53 (58.2) | 16 (66.7) | 2 (33.3) | |||
23–25 | 10 (10.5) | 6 (17.6) | 0 (0) | 1 (7.1) | 13 (14.3) | 1 (4.2) | 1 (16.7) | |||
25 ≤ | 9 (9.5) | 4 (11.8) | 1 (16.7) | 1 (7.1) | 10 (11.0) | 2 (8.3) | 1 (16.7) | |||
Pregnancy stress | 47.4 (9.8) | 59.3 (7.8) | 57.3 (11.3) | 0.000 | 56.9 (7.9) | 50.4 (10.8) | 46.4 (8.7) | 58.0 (13.3) | 0.017 | |
Cortisol | 4.1 (4.2) | 4.9 (3.1) | 7.3 (8.2) | 0.171 | 6.8 (6.6) | 4.3 (3.7) | 4.1 (4.5) | 2.6 (1.1) | 0.189 |
Variables | Categories | Depressive Symptoms Trajectory Groups | Anxiety Trajectory Groups | ||||
---|---|---|---|---|---|---|---|
OR | p | 95% CI | OR | p | 95% CI | ||
Age | <35 | 1.179 | 0.755 | 0.42–3.32 | 0.603 | 0.273 | 0.24–1.49 |
≥35 | |||||||
Education | ≤High school | 1.192 | 0.722 | 0.45–3.14 | 1.079 | 0.855 | 0.48–2.45 |
College | |||||||
Graduate | |||||||
Employment | No | 0.975 | 0.939 | 0.51–1.87 | 0.751 | 0.362 | 0.41–1.39 |
Yes | |||||||
Household income | Very low | 1.001 | 0.680 | 0.998–1.003 | 0.999 | 0.448 | 0.996–1.001 |
Low | |||||||
Middle | |||||||
High | |||||||
Planned pregnancy | No | 0.995 | 0.868 | 0.94–1.06 | 1.002 | 0.160 | 0.999–1.005 |
Yes | |||||||
Pre-Pregnancy Regular exercise | No | 1.303 | 0.674 | 0.38–4.47 | 0.646 | 0.405 | 0.23–1.81 |
Yes | |||||||
Pre-Pregnancy BMI | Underweight | 1.319 | 0.373 | 0.72–2.42 | 0.979 | 0.936 | 0.59–1.63 |
Healthy weight | |||||||
Overweight | |||||||
Obese | |||||||
Pregnancy stress | 1.133 | <0.001 | 1.08–1.19 | 1.088 | <0.001 | 1.04–1.14 | |
Cortisol level | ≤75% | 0.590 | 0.375 | 0.18–1.89 | 0.566 | 0.241 | 0.22–1.47 |
>75% |
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Lee, H.; Kim, K.-E.; Kim, M.-Y.; Park, C.G.; Han, J.Y.; Choi, E.J. Trajectories of Depressive Symptoms and Anxiety during Pregnancy and Associations with Pregnancy Stress. Int. J. Environ. Res. Public Health 2021, 18, 2733. https://doi.org/10.3390/ijerph18052733
Lee H, Kim K-E, Kim M-Y, Park CG, Han JY, Choi EJ. Trajectories of Depressive Symptoms and Anxiety during Pregnancy and Associations with Pregnancy Stress. International Journal of Environmental Research and Public Health. 2021; 18(5):2733. https://doi.org/10.3390/ijerph18052733
Chicago/Turabian StyleLee, Hyejung, Ki-Eun Kim, Mi-Young Kim, Chang Gi Park, Jung Yeol Han, and Eun Jeong Choi. 2021. "Trajectories of Depressive Symptoms and Anxiety during Pregnancy and Associations with Pregnancy Stress" International Journal of Environmental Research and Public Health 18, no. 5: 2733. https://doi.org/10.3390/ijerph18052733