Exploring early pregnancy predictors of postnatal anxiety and depression: a prospective study

Postnatal anxiety and depression are common complications of pregnancy and childbirth. These conditions have been linked to disruptions to mother-infant attachment and can potentially lead to adverse effects on child development. To help prevent these adverse consequences, early identification of pregnant women at high risk of postnatal anxiety and depression could help ensure timely support and treatment. The aim of this study was to identify key early pregnancy factors that predict postnatal psychological distress and to characterise their associations with postnatal anxiety and depression. The study population was recruited during the first trimester of pregnancy, with baseline data collected at the time of the women’s first antenatal consultation. Postnatal outcome data were collected eight weeks postpartum. Symptoms of anxiety and depression were dichotomised using standard cut-off scores in the self-report Hospital Anxiety and Depression Scale (HADS). Multiple imputation was performed to address missing outcome data. Key predictive variables for postnatal anxiety and depression were identified using an analysis of the relative importance. Associations between these predictors and postnatal anxiety and depression were examined using multivariable logistic regression analyses. Negative life events with persistent impact during early pregnancy were significantly associated with symptoms of postnatal anxiety. Increased depression symptoms in early pregnancy were significantly associated with postnatal depression symptoms. Addressing recent life stressors and psychological difficulties at antenatal consultations could potentially assist clinicians in early identification of women at an increased risk of postnatal anxiety and depression.