TY - JOUR
T1 - Prenatal stress from the COVID-19 pandemic predicts maternal postpartum anxiety as moderated by psychological factors
T2 - The Australian BITTOC Study
AU - Di Paolo, Amber Lee
AU - King, Suzanne
AU - McLean, Mia A.
AU - Lequertier, Belinda
AU - Elgbeili, Guillaume
AU - Kildea, Sue
AU - Dahlen, Hannah G.
N1 - Funding Information:
This work was supported by the Sydney Partnership for Health, Education, Research and Enterprise (SPHERE) Maternal, Newborn and Women's Clinical Academic Group (MNW CAG to Dr. Hannah Dahlen). Additional funding was received from Charles Darwin University Rainmaker Readiness Grant (Pregnant During the Pandemic Grant # 33377286 ). Funding sources had no involvement in the study design, in the collection, analysis and interpretation of data, in the writing of the paper, or in the decision to submit the article for publication. Guillaume Elgbeili was supported by a grant from the Canadian Institutes of Health Research (CIHR # PJT-148903 ) awarded to S. King and colleagues.
Publisher Copyright:
© 2022
PY - 2022/10/1
Y1 - 2022/10/1
N2 - Background: While there have been reports of increased perinatal anxiety during the COVID-19 pandemic (Stepowicz et al., 2020), there has been a lack of research on the relative importance of objective hardship and subjective distress. In this study, we explored the extent to which resilience, tolerance of uncertainty, and cognitive appraisal of the pandemic's consequences moderate the effect of prenatal objective hardship and subjective distress due to the pandemic on 2-month postpartum anxiety. Methods: Data were collected as part of the Birth in the Time of COVID (BITTOC) study. We measured objective hardship and subjective distress, mental health, and potential psychological moderators in 419 pregnant women residing in Australia, and at two months postpartum. Hierarchical multiple regressions were used. Results: Objective hardship and subjective distress independently predicted postpartum anxiety. All three psychological factors moderated the effect of objective hardship on anxiety. For women with low/neutral resilience, or low/moderate tolerance of uncertainty, or a negative cognitive appraisal, greater objective hardship predicted higher postpartum anxiety. Conversely, for women with high resilience, or high tolerance of uncertainty, or neutral/positive cognitive appraisal, there was no association. Only a neutral/positive cognitive appraisal significantly buffered the effect of subjective distress on anxiety. Limitations: Participants self-selected themselves into the study. The generalizability of our results could be restricted to women of higher socio-economic status. Conclusions: These findings help us better understand options for intervention and assessment of vulnerable women during times of stress, along with the mechanisms by which COVID-related stress during pregnancy contributes to postpartum anxiety.
AB - Background: While there have been reports of increased perinatal anxiety during the COVID-19 pandemic (Stepowicz et al., 2020), there has been a lack of research on the relative importance of objective hardship and subjective distress. In this study, we explored the extent to which resilience, tolerance of uncertainty, and cognitive appraisal of the pandemic's consequences moderate the effect of prenatal objective hardship and subjective distress due to the pandemic on 2-month postpartum anxiety. Methods: Data were collected as part of the Birth in the Time of COVID (BITTOC) study. We measured objective hardship and subjective distress, mental health, and potential psychological moderators in 419 pregnant women residing in Australia, and at two months postpartum. Hierarchical multiple regressions were used. Results: Objective hardship and subjective distress independently predicted postpartum anxiety. All three psychological factors moderated the effect of objective hardship on anxiety. For women with low/neutral resilience, or low/moderate tolerance of uncertainty, or a negative cognitive appraisal, greater objective hardship predicted higher postpartum anxiety. Conversely, for women with high resilience, or high tolerance of uncertainty, or neutral/positive cognitive appraisal, there was no association. Only a neutral/positive cognitive appraisal significantly buffered the effect of subjective distress on anxiety. Limitations: Participants self-selected themselves into the study. The generalizability of our results could be restricted to women of higher socio-economic status. Conclusions: These findings help us better understand options for intervention and assessment of vulnerable women during times of stress, along with the mechanisms by which COVID-related stress during pregnancy contributes to postpartum anxiety.
KW - Anxiety
KW - Cognitive appraisal
KW - COVID-19
KW - Prenatal maternal stress
KW - Resilience
KW - Tolerance of uncertainty
UR - http://www.scopus.com/inward/record.url?scp=85133870455&partnerID=8YFLogxK
U2 - 10.1016/j.jad.2022.06.055
DO - 10.1016/j.jad.2022.06.055
M3 - Article
C2 - 35760187
AN - SCOPUS:85133870455
SN - 0165-0327
VL - 314
SP - 68
EP - 77
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -