# Prevalence and associated factors of anxiety in postpartum women

## TL;DR

This study finds that nearly a quarter of postpartum women in Spain experience anxiety, with risk factors including depression, poor mother-baby bonding, and low income.

## Contribution

The study identifies specific risk and protective factors for postpartum anxiety using a large Spanish sample and validated tools.

## Key findings

- 36.1% of postpartum women experienced mild anxiety, with higher rates linked to depression, smoking, and baby health issues.
- Positive mother-baby bonding and higher income were protective against postpartum anxiety.
- Moderate to severe anxiety was notably associated with high depression scores and poor healthcare treatment.

## Abstract

Postpartum anxiety affects approximately 1 in 4 women, with significant implications for both mothers and newborns. This study aimed to identify factors associated with postpartum anxiety and to assess its prevalence.

A cross-sectional study was carried out with women in the postpartum period in Spain. To measure attachment (VAMF bonding and VAMF attachment), the Maternal-Child Bond and Attachment - VAMF tool was used. Purpose sampling method was used to collect data from postpartum and postnatal consultations in medical centers. Sociodemographic and obstetric variables, anxiety level (GAD-7), risk of intimate partner violence (WAST), and risk of postpartum depression (EPDS) were obtained. Odds ratios (ORs) and adjusted odds ratios (AORs) with their respective 95% confidence intervals (CIs) were calculated.

A total of 820 women participated, 36.1% (296) experienced mild anxiety, 8.5% (70) moderate anxiety, and 2.7% (22) severe anxiety. Key risk factors for anxiety included higher EPDS scores (adjusted odds ratio, AOR=1.68; 95% CI: 1.55–1.81), smoking (AOR=1.97; 95% CI: 1.01–3.82), a history of mental health issues (AOR=1.77; 95% CI: 1.13–2.79), and challenges related to the baby's health (AOR=2.70; 95% CI: 1.34–5.47). Additionally, a high-risk score on the WAST was linked to increased anxiety (AOR=1.53; 95% CI: 1.01–2.31). Conversely, protective factors included a positive mother–baby bonding score (AOR=0.90; 95% CI: 0.85–0.96) and a monthly income of 1000–1999 € (AOR=0.55; 95% CI: 0.31–0.95). For moderate to severe anxiety, a high EPDS score remained a notable risk factor (AOR=1.35; 95% CI: 1.26–1.44), while positive bonding (AOR=0.92; 95% CI: 0.85–0.98), higher income (>2000 €) (AOR=0.35; 95% CI: 0.15–0.80), and favorable treatment by healthcare providers significantly reduced anxiety risk (AOR=0.21; 95% CI: 0.07–0.70).

The prevalence of anxiety in women after childbirth is high. Depression, poor bonding, and economic status are factors that influence the onset of postpartum anxiety.