Associations between pregnancy-related anxiety and positive health behaviors across pregnancy in a sample of low-income, vulnerable women.
Positive health behaviours during pregnancy are essential for maternal, fetal, and child wellbeing but can be compromised by poor maternal mental health. Pregnancy-related anxiety (PRA) - including concerns about bodily changes across pregnancy, childbirth fears, and worries about fetal/infant health - reduces positive health behaviours in studies of mostly low-risk women.
It is unclear whether this relation between PRA and positive health behaviours exists in lower-income women with barriers to engaging in positive health behaviours, or how it is influenced by other mental health concerns sometimes not considered in prior studies.
This is a longitudinal study of 270 women from the community oversampled for economic vulnerability and high stress assessed three times across pregnancy [weeks 17.4 (SD 2.3), 24.1 (SD 1.5), and 33.1 (SD 1.3)] for PRA (PRAQ-R2), other mental health concerns (depression - EPDS, anxiety - STAI, PTSD - PCL-5), and positive health behaviours (PHBS). Multivariate latent growth curve modeling was used for data analyses.
There was a significant negative relation in the full sample between PRA and positive health behaviours only at our earliest timepoint. However, further analysis comparing women below and above the clinical cutoffs for the frequency and severity of other mental health concerns and also including covariates identified that PRA was associated with lower concurrent positive health behaviours only in the group with high levels of other mental health symptoms.
PRA is not necessarily related to positive health behaviours in low-income and vulnerable women, and other mental health concerns must be considered. Earlier pregnancy PRA screening and support could increase positive health behaviours particularly for women with high levels of other mental health symptoms.
It is unclear whether this relation between PRA and positive health behaviours exists in lower-income women with barriers to engaging in positive health behaviours, or how it is influenced by other mental health concerns sometimes not considered in prior studies.
This is a longitudinal study of 270 women from the community oversampled for economic vulnerability and high stress assessed three times across pregnancy [weeks 17.4 (SD 2.3), 24.1 (SD 1.5), and 33.1 (SD 1.3)] for PRA (PRAQ-R2), other mental health concerns (depression - EPDS, anxiety - STAI, PTSD - PCL-5), and positive health behaviours (PHBS). Multivariate latent growth curve modeling was used for data analyses.
There was a significant negative relation in the full sample between PRA and positive health behaviours only at our earliest timepoint. However, further analysis comparing women below and above the clinical cutoffs for the frequency and severity of other mental health concerns and also including covariates identified that PRA was associated with lower concurrent positive health behaviours only in the group with high levels of other mental health symptoms.
PRA is not necessarily related to positive health behaviours in low-income and vulnerable women, and other mental health concerns must be considered. Earlier pregnancy PRA screening and support could increase positive health behaviours particularly for women with high levels of other mental health symptoms.
Authors
Lonstein Lonstein, Martinez-Torteya Martinez-Torteya, Nuttall Nuttall, Levendosky Levendosky, Bogat Bogat, Muzik Muzik
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