Poster #36 - Trajectories of maternal emotions across pregnancy and early postpartum: effects of parity and child sex

• In Event: Poster Session 07

Abstract

Background and Aims: Research suggests that there are significant changes in maternal emotional status across phases of pregnancy (Rallis et al., 2014; Liou et al., 2014; Asselmann et al., 2020). However, while several studies have investigated trajectories of depression and anxiety, few have focused on pregnant women’s levels of stress, and studies on positive emotions are almost completely lacking. The aim of the current study was to identify patterns of women’s emotions (stress, depressive symptoms, anxiety, positive and negative emotions) from early pregnancy through the postpartum period and to examine whether those patterns differ depending on parity and child sex.
Study population: Women were recruited in early pregnancy during their antenatal medical checkups in collaboration with three gynecological clinics in Prague, Czech Republic. Healthy, low-risk women (N=161) aged 18–44 years (mean age=31.8, SD=4.3) with singleton pregnancies took part.
Methods: Women completed questionnaires twice in each pregnancy trimester, and then again twice after childbirth (in the first week and at 6–21 weeks postpartum). These included the Edinburgh Postnatal Depression Scale (Cox & Holden, 2003), the short form of the state scale of the State-Trait Anxiety Inventory (STAI; Marteau & Bekker, 1992), the Perceived Stress Scale (Cohen, Kamarck, & Mermelstein, 1994), and the Positive and Negative Affect Schedule (PANAS; Watson, Clark, & Tellegen, 1988). Longitudinal trends in maternal emotions were analyzed using linear mixed effect models (LMM). Nonlinear temporal trends were fitted by natural cubic splines. LMM was used to examine interactions between time point of questionnaire completion and fetal sex and parity.
Results: For all emotions, we observed significant nonlinear longitudinal changes across the study period (Figure 1). Depressive symptoms decreased between the 1st and 2nd trimesters, reaching their lowest point in mid-pregnancy, with an increasing trend approaching childbirth, peaking after delivery, and declining in the postpartum period. Anxiety was highest at the beginning of pregnancy, decreased during the 1st trimester and remained stable across the 2nd and 3rd trimesters and early postpartum. Perceived stress and negative affect showed a similar course pattern: a slightly decreasing trend across pregnancy, increasing prior to childbirth, peaking shortly after delivery, and declining again in the postpartum period. Positive affect was lowest at the turn of the 1st and 2nd trimesters, peaked in mid-pregnancy, declined towards childbirth, and increased again in the postpartum period. Primiparae versus multiparae and women expecting a boy versus girl reported significantly higher levels of perceived stress. Multiparae experienced a gradual decrease in anxiety levels throughout pregnancy and postpartum, while primiparae reported their lowest anxiety in mid-pregnancy, followed by an increase with approaching childbirth. After delivery, depressive symptoms decreased in multiparae (not in primiparae) and negative affect peaked in primiparae (not in multiparae).
Conclusions: Pregnancy and the early postpartum period is a time of considerable changes in both negative end positive emotions, with different emotions showing distinct longitudinal trends. In line with existing research, negative emotions appear to reach their lowest levels in mid-pregnancy. Parity and child sex modulated trajectories of negative but not positive emotions.

Authors

• Lea Takacs, Charles University
  Presenting Author

• Sarka Kankova, Charles University

• Jana Hlavacova, Charles University

• Catherine Monk, Columbia University Irving Medical Center

• Sam Putnam, Bowdoin College

• Jakub Kreisinger, Charles University