Cited by 253Maternal Mental Health During Pregnancy and PostpartumMaternal and Neonatal HealthcareMaternal and Perinatal Health Interventions

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Depression and anxiety in perinatal period: prevalence and risk factors in an Italian sample

Giardinelli, L., Innocenti, A., Benni, L., Stefanini, M. C., Lino, G., Lunardi, C., Svelto, V., Afshar, S., Bovani, R., Castellini, G., Faravelli, C.·2012·Archives of Women s Mental Health

DOI 10.1007/s00737-011-0249-8

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Abstract

Accumulating evidence suggests that pregnancy does not protect women from mental illness. The aim of this study was to assess the prevalence, sociodemographic correlates, and the risks factors for perinatal depression and anxiety. Five hundred ninety women between 28th and the 32nd gestational weeks were recruited and submitted to a sociodemographic, obstetric, and psychological interview. The Edinburgh Postnatal Depression Scale (EPDS) and the state-trait anxiety inventory (STAI-Y) were also administered in antenatal period and 3 months postnatally. The Structured Clinical Interview for DSM-IV (SCID-I) was used to diagnose mood and anxiety disorders. Three months after delivery, EPDS was administered by telephone interview. Women with an EPDS score ≥10 were 129 in antenatal period (21.9%) and 78 in postnatal period (13.2%). During pregnancy 121 women (20.5%) were positive for STAI-Y state and 149 women (25.3%) for STAI-Y trait. The most important risk factors for antenatal depression are: foreign nationality, conflictual relationship with family and partner, and lifetime psychiatric disorders. The principal risk factors for postnatal depression are: psychiatric disorders during pregnancy and artificial reproductive techniques. Psychiatric disorders, during and preceding pregnancy, are the strongest risk factors for antenatal state and trait anxiety. Antenatal depressive and anxiety symptoms appear to be as common as postnatal symptoms. These results provide clinical direction suggesting that early identification and treatment of perinatal affective disorders is particularly relevant to avoid more serious consequences for mothers and child.

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Maguire, P. N., Clark, G. I., & Wootton, B. M. (2018) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2018.10.002 · Cited by 50
Deprivation and poor psychosocial support are key determinants of late antenatal presentation and poor fetal outcomes-a combined retrospective and prospective study
Kapaya, H., Mercer, E., Boffey, F., Jones, G. L., Mitchell, C. A., & Anumba, D. O. C. (2015) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-015-0753-3 · Cited by 46
“For example, the mean score on the anxiety data for both groups was relatively low compared to scores reported previously by other studies [28].”
Result
Anxiety and depressive symptoms in women and men from early pregnancy to 30 months postpartum
Canário, C., & Figueiredo, B. (2017) · Journal of Reproductive and Infant Psychology · doi:10.1080/02646838.2017.1368464 · Cited by 48
“Multiparous parents presented more anxiety and depression symptoms than primiparous parents at the first pregnancy trimester, also confirmed by previous studies (e.g. Condon & Esuvaranathan, 1990; Giardinelli et al., 2012; Melo et al., 2012).”
BackgroundResultInfluential
Supporting perinatal anxiety in the digital age; a qualitative exploration of stressors and support strategies
Harrison, V., Moore, D., & Lazard, L. (2020) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-020-02990-0 · Cited by 57
Longitudinal effects of dysfunctional perfectionism and avoidant personality style on postpartum mental disorders: Pathways through antepartum depression and anxiety
Oddo-Sommerfeld, S., Hain, S., Louwen, F., & Schermelleh-Engel, K. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.11.040 · Cited by 54
“The prevalence of 20% for antepartum depression (APD) appears to be higher than that of PPD (Giardinelli et al., 2011; Hübner-Liebermann et al., 2012; Milgrom et al., 2008).”
Background
Antenatal depression: an artefact of sleep disturbance?
Mellor, R., Chua, S. C., & Boyce, P. M. (2014) · Archives of Women s Mental Health · doi:10.1007/s00737-014-0427-6 · Cited by 47
“The factors that had a significant correlation with EPDS score on bivariate analysis were included in the model, along with recent immigration, which has been identified as a risk factor for antenatal depression (Miszkurka et al. 2012; Giardinelli et al. 2012; Lau et al. 2011).”
BackgroundMethod
Maternal-fetal attachment and its correlates in a sample of Italian women: a study using the Prenatal Attachment Inventory
Barone, L., Lionetti, F., & Dellagiulia, A. (2014) · Journal of Reproductive and Infant Psychology · doi:10.1080/02646838.2014.883596 · Cited by 43
“66), higher than that found in previous studies (Giardinelli et al., 2012) on low-risk Italian pregnant women (mean = 10.”
ResultInfluential
The Postpartum Partner Support Scale: Development, psychometric assessment, and predictive validity in a Canadian prospective cohort
Dennis, C., Brown, H. K., & Brennenstuhl, S. (2017) · Midwifery · doi:10.1016/j.midw.2017.07.018 · Cited by 44
Structure-Function Relationship of Changes in Visual Field Indices with Quadrant and Average Retinal Nerve Fiber Layer Thickness in the Eyes with Exfoliation
Lauš, K. N. (2017) · Acta Clinica Croatica · doi:10.20471/acc.2017.56.04.05 · Cited by 42
Adjusting an Available Online Peer Support Platform in a Program to Supplement the Treatment of Perinatal Depression and Anxiety
Baumel, A., & Schueller, S. M. (2016) · JMIR Mental Health · doi:10.2196/mental.5335 · Cited by 41
“More than 15% of women experience symptoms of depression and anxiety during this period [1-3].”
Perinatal citalopram does not prevent the effect of prenatal stress on anxiety, depressive‐like behaviour and serotonergic transmission in adult rat offspring
Zohar, I., Shoham, S., & Weinstock, M. (2015) · European Journal of Neuroscience · doi:10.1111/ejn.13150 · Cited by 41
“The incidence of chronic anxiety disorder and depression is elevated in pregnant women exposed to poverty, crowding, poor social integration and intramarital tension (Giardinelli et al., 2012; Husain et al., 2012; Miszkurka et al., 2012).”
Background
Subconstructs of the Edinburgh Postnatal Depression Scale in a multi-ethnic inner-city population in the U.S.
Chiu, Y.-H. M., Sheffield, P. E., Hsu, H. L., Goldstein, J. M., Curtin, P. C. P., & Wright, R. J. (2017) · Archives of Women s Mental Health · doi:10.1007/s00737-017-0765-2 · Cited by 43
“(Le Strat et al. 2011; Miller et al. 2006), and anxiety might even be more common than depression in some postpartum populations (Giardinelli et al. 2012; Goodman et al. 2016; Matthey 2008; Woolhouse et al. 2009).”
Prevalence of maternal antenatal anxiety and its association with demographic and socioeconomic factors: A multicentre study in Italy
Cena, L., Mirabella, F., Palumbo, G., Gigantesco, A., Trainini, A., & Stefana, A. (2020) · European Psychiatry · doi:10.1192/j.eurpsy.2020.82 · Cited by 40
“Furthermore, consistent with previous studies, our results show that antenatal anxiety is more prevalent in women who have unplanned pregnancies [43,54] and who have living children at the time of the current pregnancy [55].”
Result
The Public’s views of mental health in pregnant and postpartum women: a population-based study
Kingston, D. E., McDonald, S., Austin, M., Hegadoren, K., Lasiuk, G. C., & Tough, S. (2014) · BMC Pregnancy and Childbirth · doi:10.1186/1471-2393-14-84 · Cited by 39
“The lack of knowledge about the influence of pre-conception and prenatal anxiety/depression on the risk of poor perinatal mental health [22-24] may reflect errant public belief that the primary causes of perinatal mental health problems are biological in nature –a key observation noted in the Australian study [13].”
Background
COVID-19-Related anxieties and parenting stress among first-time mothers and fathers in their first year of parenthood
Ben‐Yaakov, O., & Ben‐Ari, O. T. –. (2021) · Psychology and Health · doi:10.1080/08870446.2021.1942875 · Cited by 38
“Parent-infant dysfunctional interactions by gender and infant’s age group. associated with infant’s age (Breitkopf et al., 2006; Don et al., 2014; Giardinelli et al., 2012; Grant et al., 2008).”
Background
Prevalence of Antenatal Anxiety in European Women: A Literature Review
Val, A., & Míguez, M. C. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20021098 · Cited by 50
“Regarding the studies that have focused on assessing anxiety [40,42,51,59,60,70], the highest rate was found in Italy [60], where figures of 25.”
Background
Changes Induced by Prenatal Stress in Behavior and Brain Morphology: Can They Be Prevented or Reversed?
Weinstock, M. (2014) · Advances in neurobiology · doi:10.1007/978-1-4939-1372-5_1 · Cited by 36
“Exposure to such adverse risk factors can also increase the incidence of depression in pregnant women (Giardinelli et al. 2012; Husain et al. 2012; Miszkurka et al. 2012; Qu et al. 2012).”
Background
Anxiety and physical health problems increase the odds of women having more severe symptoms of depression
Weiss, S., Simeonova, D. I., Kimmel, M., Battle, C., Maki, P., & Flynn, H. A. (2016) · Archives of Women's Mental Health · doi:10.1007/s00737-015-0575-3 · Cited by 36
Comorbid anxiety and depression: a community-based study examining symptomology and correlates during the postpartum period
Ramakrishna, S., Cooklin, A., & Leach, L. (2019) · Journal of Reproductive and Infant Psychology · doi:10.1080/02646838.2019.1578870 · Cited by 35
Psychological health of women who have conceived using assisted reproductive technology in Taiwan: findings from a longitudinal study
Huang, M., Kao, C., Lin, K., Hwang, J., Puthussery, S., & Gau, M. (2019) · BMC Women s Health · doi:10.1186/s12905-019-0801-7 · Cited by 38
Correlation between postpartum depression and spousal support and factors affecting postpartum depression
Kızılırmak, A., Calpbinici, P., Tabakan, G., & Kartal, B. (2020) · Health Care For Women International · doi:10.1080/07399332.2020.1764562 · Cited by 37
“Researchers investigating PPD risk (Andersson et al., 2006; Giardinelli et al., 2012; Hahn-Holbrook et al., 2018; Khalifa et al., 2015; Park et al., 2015; Yusuff et al., 2015) have revealed differences in terms of cutoff point of the scales, postpartum time and location.”
Background
Demographic, maternal, and infant health correlates of post‐partum depression in Jordan
Safadi, R., Abushaikha, L. A., & Ahmad, M. M. (2015) · Nursing and Health Sciences · doi:10.1111/nhs.12268 · Cited by 34
Perceived Paternal Involvement, Relationship Satisfaction, Mothers' Mental Health and Parenting Stress: A Multi-Sample Path Analysis
deMontigny, F., Gervais, C., Pierce, T., & Lavigne, G. L. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.578682 · Cited by 37
“The MANOVA indicated that the mothers whose youngest child was 0–24 months of age fared slightly better overall on study variables than those whose youngest child was 25 months or older [F(7,439) = 4.”
Background
Characterizing the nature of worry in a sample of perinatal women with generalized anxiety disorder
Goldfinger, C., Green, S. M., Furtado, M., & McCabe, R. E. (2019) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2413 · Cited by 40
Prevalence of Depression during Pregnancy in Spanish Women: Trajectory and Risk Factors in Each Trimester
Míguez, M. C., & Vázquez, M. B. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18136789 · Cited by 42
“[30] suggested that this relationship may be due to the fact that not working implies having a smaller social support network and some degree of isolation.”
BackgroundResultInfluential
A Longitudinal Study on Motherhood and Well-Being: Developmental and Clinical Implications
Fave, A. D., Pozzo, M., Bassi, M., & Cetin, I. (2013) · Terapia psicológica · doi:10.4067/s0718-48082013000100003 · Cited by 33
“As suggested in recent studies (Giardinelli et al., 2011; Chaudron & Nirodi, 2010), we adopted a cut-off point of 10 in order to grant high sensitivity in the identification of both minor and major depression.”
Result
State anxiety in pregnancies affected by obstetric complications: A systematic review
Fischbein, R. L., Nicholas, L., Kingsbury, D. M., Falletta, L. M., Baughman, K. R., & VanGeest, J. B. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.07.007 · Cited by 38
Perspectives on Early Screening and Prompt Intervention to Identify and Treat Maternal Perinatal Mental Health. Protocol for a Prospective Multicenter Study in Italy
Cena, L., Palumbo, G., Mirabella, F., Gigantesco, A., Stefana, A., Trainini, A., Tralli, N., & Imbasciati, A. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.00365 · Cited by 31
Exploring women’s experiences of identifying, negotiating and managing perinatal anxiety: a qualitative study
Oh, S. K., Chew-Graham, C. A., Silverwood, V., Shaheen, S. A., Walsh-House, J., Sumathipala, A., & Kingstone, T. (2020) · BMJ Open · doi:10.1136/bmjopen-2020-040731 · Cited by 30
Pregnancy-related anxiety symptoms and associated factors amongst pregnant women attending a tertiary hospital in south-west Nigeria
Akinsulore, A., Temidayo, A. M., Oloniniyi, I. O., Olalekan, B. O., & Oladimeji, Y. (2021) · South African Journal of Psychiatry · doi:10.4102/sajpsychiatry.v27i0.1616 · Cited by 29
Predictors of Postpartum Depression among Italian Women: A Longitudinal Study
Molgora, S., Saita, E., Carones, M. B., Ferrazzi, E. M., & Facchin, F. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19031553 · Cited by 33
“Based on previous studies on similar cohorts, a cut-off score of 40 or higher was used to identify both state and trait clinical anxiety [15,57].”
Method
Association of Prepregnancy Dietary Patterns and Anxiety Symptoms from Midpregnancy to Early Postpartum in a Prospective Cohort of Brazilian Women
Vilela, A. A. F., Pinto, T., Rebelo, F. M., Benaim, C., Lepsch, J., Dias-Silva, C. H., de Castro, M. B. T., & Kac, G. (2015) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2015.01.007 · Cited by 33
Psychological distress profiles in expectant mothers: What is the association with pregnancy-related and relational variables?
Molgora, S., Fenaroli, V., & Saita, E. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.10.045 · Cited by 27
Prevalence and related factors of common mental disorders during pregnancy in Japan: a cross-sectional study
Usuda, K., Nishi, D., Makino, M., Tachimori, H., Matsuoka, Y., Sano, Y., Konishi, T., & Takeshima, T. (2016) · BioPsychoSocial Medicine · doi:10.1186/s13030-016-0069-1 · Cited by 28
“2 %, respectively, which are much lower figures than seen in other countries [3, 6–11].”
Result
A meta-synthesis of women’s experiences of online forums for maternal mental illness and stigma
Moore, D., Drey, N., & Ayers, S. (2019) · Archives of Women s Mental Health · doi:10.1007/s00737-019-01002-1 · Cited by 33
“Perinatal mental illness (PMI) is a common health condition with a prevalence of approximately 15% and may be higher in lower income countries (Fisher et al. 2012; Giardinelli et al. 2012; Leung and Kaplan 2009; Ross and McLean 2006).”
Background
Comparing the prevalence and the risk profile for antenatal depressive symptoms across cultures
Corbani, I. E., Rucci, P., Iapichino, E., Bollani, M. Q., Cauli, G., Ceruti, M. R., Gala, C., & Bassi, M. (2017) · International Journal of Social Psychiatry · doi:10.1177/0020764017725543 · Cited by 26
“Giardinelli et al. (2012) reported that the immigrant status confers a higher risk of depression during pregnancy, and Stewart, Gagnon, Wahoush, and Dougherty (2008) reported that ‘newcomers’, including immigrants, asylum seekers and refugees, were significantly more likely than Canadian-born women…”
Background
Prevalence of anxiety and depression and their associated risk factors throughout pregnancy and postpartum: a prospective cross-sectional descriptive multicentred study
Jimènez-Barragan, M., Falguera‐Puig, G., Curto-Garcia, J. J., Monistrol, O., Coll-Navarro, E., Tarragó-Grima, M., Ezquerro-Rodriguez, O., Ruiz, A. C., Codina, L., Urquizu, X., et al. (2024) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-024-06695-6 · Cited by 42
“Although anxiety and depression vary considerably depending on the population assessed [8, 9], this is certainly a high percentage, higher than previously reported in other studies [2, 3, 5–7].”
BackgroundResult
Maternal Anxiety Related to Prenatal Diagnoses of Fetal Anomalies That Require Surgery
Wilpers, A. B., Kennedy, H. P., Wall, D., Funk, M., & Bahtiyar, M. O. (2017) · Journal of Obstetric, Gynecologic & Neonatal Nursing · doi:10.1016/j.jogn.2017.02.001 · Cited by 24
Healthcare professionals’ perspectives on identifying and managing perinatal anxiety: a qualitative study
Silverwood, V., Nash, A., Chew-Graham, C. A., Walsh-House, J., Sumathipala, A., Bartlam, B., & Kingstone, T. (2019) · British Journal of General Practice · doi:10.3399/bjgp19x706025 · Cited by 26
Psychiatric Risk Factors for Postpartum Depression: A Systematic Review
Tambelli, R., Tosto, S., & Favieri, F. (2025) · Behavioral Sciences · doi:10.3390/bs15020173 · Cited by 34
The Efficacy of Digital Cognitive–Behavioral Interventions in Supporting the Psychological Adjustment and Sleep Quality of Pregnant Women with Sub-Clinical Symptoms: A Systematic Review and Meta-Analysis
Mancinelli, E., Bassi, G., Gabrielli, S., & Salcuni, S. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19159549 · Cited by 21
Serum docosahexaenoic acid (DHA) is inversely associated with anxiety disorders in early pregnancy
Verly-Miguel, M., Farias, D. R., Pinto, T., Lepsch, J., Nardi, A. E., & Kac, G. (2014) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2014.12.002 · Cited by 28
Evaluation of factors related to maternal anxiety during pregnancy among women referred to Tabriz primary care centers
Mahini, E., Hakimi, S., Shahrokhi, H., Salahi, B., Baniadam, K. O., & Ranjbar, F. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-04823-8 · Cited by 29
Impact of parental perinatal depressive and anxiety symptoms trajectories on early parent-infant impaired bonding: a cohort study in east and west coasts of Malaysia
Nasreen, H. E., Pasi, H., Aris, M. A., Rahman, J. A., Rus, R. M., & Edhborg, M. (2021) · Archives of Women s Mental Health · doi:10.1007/s00737-021-01165-w · Cited by 20

Authors: Giardinelli, L., Innocenti, A., Benni, L., Stefanini, M. C., Lino, G., Lunardi, C., Svelto, V., Afshar, S., Bovani, R., Castellini, G., & Faravelli, C.
Affiliations: University of Florence (IT)
Corresponding author: Giardinelli, L.
ORCID: Castellini, G.
Venue: Archives of Women s Mental Health
Publisher: Springer Science and Business Media LLC
Published: 2011-12-29
Volume: 15
Issue: 1
Pages: 21-30
ISSN: 1434-1816 (ISSN-L)
1435-1102
DOI: 10.1007/s00737-011-0249-8
OpenAlex: W2097816165
Cited by: 253
References: 76
Citations by year: 2026: 10 · 2025: 14 · 2024: 25 · 2023: 21 · 2022: 23 · 2021: 24 · 2020: 26 · 2019: 25 · 2018: 20 · 2017: 14 · 2016: 12 · 2015: 17 · 2014: 15 · 2013: 3 · 2012: 3
FWCI: 6.60
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (tdm)
Locations: Archives of Women s Mental Health (publishedVersion)
PubMed (publishedVersion)
Florence Research (University of Florence) (submittedVersion)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Keywords: perinatal depression, perinatal anxiety, antenatal depression, postpartum depression, pregnancy, risk factors, prevalence, sociodemographic correlates, foreign nationality, family conflict, lifetime psychiatric disorders, artificial reproductive techniques, Edinburgh Postnatal Depression Scale, State-Trait Anxiety Inventory
MeSH terms: Adult, Anxiety Disorders, Depressive Disorder, Female, Humans, Interviews as Topic, Italy, Pregnancy, Pregnancy Complications, Psychiatric Status Rating Scales, Risk Factors, Comorbidity, Prevalence, Perinatal Care, Young Adult

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Depression and anxiety in perinatal period: prevalence and risk factors in an Italian sample

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