High Pregnancy-Related Anxiety and Prenatal Depressive Symptoms as Predictors of Intention to Breastfeed and Breastfeeding Initiation
Open accessAbstract
BACKGROUND: Perinatal mood disorders affect up to 20% of women in the United States. Little is known about how disorders in maternal mood may affect rates of breastfeeding. OBJECTIVE: To determine the impact of prenatal depressive symptoms and high pregnancy-related anxiety on (1) prenatal intention to breastfeed and (2) breastfeeding initiation. METHODS: We prospectively followed 1436 pregnant women enrolled in the cohort study Project Viva. The main outcome measures were (1) mother's second trimester self-report of intention to use all or mostly formula in the first week of life and (2) failure to initiate breastfeeding. We defined prenatal depressive symptoms as a second trimester Edinburgh Postpartum Depression Scale (EPDS) score of > or =13 and high pregnancy-related anxiety as a "very much" response to three or more questions on a first trimester pregnancy anxiety scale. RESULTS: Of the 1436 participants, 9% (n = 125) had prenatal depressive symptoms indicative of depression, and 10% (n = 141) reported high pregnancy-related anxiety; 11% (n = 159) intended to give mostly or only formula in the first week of life, and 86% (n = 1242) initiated breastfeeding. In multivariate analyses, women with prenatal depressive symptoms (OR 1.92, 95% CI 1.11, 3.33) and high pregnancy-related anxiety (OR 1.99, 95% CI 1.12, 3.54) were roughly two times more likely than women without these mood disorders to plan to formula feed. However, neither prenatal depressive symptoms (OR 1.06, 95% CI 0.61, 1.84) nor high pregnancy-related anxiety (OR 1.28, 95% CI 0.74, 2.20) was associated with failure to initiate breastfeeding. CONCLUSIONS: In a healthcare setting highly supportive of breastfeeding, women with prenatal depressive symptoms and possibly those with high pregnancy-related anxiety were less likely to plan prenatally to breastfeed, although this tendency did not translate into lower breastfeeding initiation rates.
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Detection of anxiety disorder symptoms in the perinatal period is associated with increased difficulties in breastfeeding for the mother, as well as shorter breastfeeding initiation and duration.
“According to the literature (a) the detection of anxiety disorder symptoms in the perinatal period is associated with increased difficulties in breastfeeding for the mother, as well as shorter breastfeeding initiation and duration [58,62,63,64,65] and (b) the symptoms of anxiety are often accompanied by depressive symptoms [66,67].”
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- Authors
- Fairlie, T. G., Gillman, M. W., & Rich-Edwards, J.
- Affiliations
- Tufts University (US)
- Harvard University (US)
- Brigham and Women's Hospital (US)
- Corresponding author
- Fairlie, Tarayn G.
- Venue
- Journal of Women's Health
- Publisher
- SAGE Publications
- Published
- 2009-07
- Volume
- 18
- Issue
- 7
- Pages
- 945-953
- ISSN
- 1059-7115 (ISSN-L)
- 1540-9996
- 1931-843X
- PMC
- PMC2851128
- OpenAlex
- W2163583935
- Cited by
- 97
- References
- 13
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 6 · 2023: 7 · 2022: 4 · 2021: 8 · 2020: 6 · 2019: 5 · 2018: 12 · 2017: 7 · 2016: 11 · 2015: 8 · 2014: 3 · 2013: 4 · 2012: 4
- FWCI
- 3.36
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Women s Health (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (HL 68041, HD 34568, ES-00002)
- National Heart, Lung, and Blood Institute (K24HL068041, HL-68041)
- National Institute of Mental Health (MH068596, R01MH068596)
- National Institute of Environmental Health Sciences (P01ES012874, P30ES000002, ES 00002)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23HD044807, HD44807, HD34568)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Medicine › Epidemiology › Breastfeeding Practices and Influences
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Keywords
- breastfeeding intention, breastfeeding initiation, prenatal depressive symptoms, pregnancy-related anxiety, perinatal mood disorders, maternal depression, bottle feeding, Project Viva cohort, Edinburgh Postnatal Depression Scale
- MeSH terms
- Adult, Anxiety, Breast Feeding, Depression, Female, Follow-Up Studies, Humans, Pregnancy, Pregnancy Complications, Prospective Studies, Surveys and Questionnaires, Women's Health, Outcome Assessment, Health Care, Depression, Postpartum, Intention, Young Adult
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