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Anxiety May Be More Common Than Depression After Pregnancy
Date:3/4/2013

By Maureen Salamon
HealthDay Reporter

MONDAY, March 4 (HealthDay News) -- Anxiety is far more common in the days after childbirth than depression, with nearly one in five new mothers reporting acute mental stress surrounding delivery and the transition to a larger family, a new study suggests.

Researchers also found that anxious new mothers were more likely to cut short breast-feeding efforts and seek out additional medical care for themselves within two weeks of delivery.

"Postpartum depression has gotten a lot more attention than anxiety ... but it's anxiety that's an acute concern and affects so many aspects of the hospital stay and postpartum course," said study author Dr. Ian Paul, a professor of pediatrics and public health sciences at the Penn State College of Medicine, in Hershey, Penn. "Childbirth tends not to be a depressing situation for a majority of women, but it is anxiety-provoking, especially for first-time moms."

The study is published online March 4 and will appear in the April print issue of the journal Pediatrics.

Paul and his colleagues evaluated more than 1,100 new mothers whose average age was 29 during their hospital stay. The researchers then followed up with phone surveys at two weeks, two months and six months after delivery to assess anxiety, depression, breast-feeding duration and health care use.

The researchers found that 17 percent of the women suffered from anxiety -- acute emotions in response to a perceived stressful, dangerous or threatening situation -- while in the hospital after childbirth. Meanwhile, 6 percent reported postpartum depression during the same time frame.

Anxiety rates later dropped markedly, hovering between 6 percent and 7 percent from two weeks to six months post-delivery. Anxiety was still reported at higher rates than depression six months after delivery, Paul said, but for most women the issue resolves on its own within weeks and doesn't require any treatment.

"The reason it's important for clinicians to know this is that it affected health outcomes such as breast-feeding," he said. "Trouble breast-feeding can be a source of a lot of acute anxiety, and then more health care [visits] for women, as well as more depression. It makes me question: Is this something we want to think about screening for?"

New mothers often are asked about depressive symptoms by pediatricians during their babies' many newborn visits, but it may be wise for doctors to add questions about anxiety as well, Paul said.

Dr. Jill Rabin, chief of ambulatory care and obstetrics and gynecology at Long Island Jewish Medical Center in New Hyde Park, N.Y., said more research is needed on the subject. But she cautioned people not to "medicalize" typical emotions surrounding major life events such as childbirth.

"I think we try a little too hard to over-think and over-medicalize things. It's important to realize that this is a normal, natural life event and any life change can cause anxiety," said Rabin, who also is head of urogynecology at the medical center. "Even if everything goes perfectly, it's still a stressor and it still has to be dealt with."

More information

Mental Health America has more about postpartum disorders.

SOURCES: Ian Paul, M.D., M.Sc., professor, pediatrics and public health sciences, and associate vice chairman for research, department of pediatrics, Penn State College of Medicine, Hershey; Jill Rabin, M.D., chief of ambulatory care, obstetrics and gynecology, and head of urogynecology, Long Island Jewish Medical Center, New Hyde Park, N.Y.; April 2013, Pediatrics


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