Prevalence and predictors of anxiety disorders amongst low-income pregnant women in urban South Africa: a cross-sectional study
2017
Anxietyis highly prevalent in many populations; however, the burden of
anxiety disordersamongst pregnant women in low-resource settings is not well documented. We investigated the prevalence and predictors of antenatal
anxiety disordersamongst low-income women living with psychosocial adversity. Pregnant women were recruited from an urban, primary level clinic in Cape Town, South Africa. The
Mini-International Neuropsychiatric Interviewdiagnostic interview assessed prevalence of
anxiety disorders. Four self-report questionnaires measured psychosocial characteristics. Logistic regression models explored demographic and socioeconomic characteristics, psychosocial risk factors and psychiatric comorbidity as predictors for
anxiety disorders. Amongst 376 participants, the prevalence of any
anxiety disorderwas 23%. Although 11% of all women had post-traumatic stress disorder, 18% of the total sample was diagnosed with other
anxiety disorders. Multivariable analysis revealed several predictors for
anxietyincluding a history of mental health problems (adjusted odds ratio [AOR] 4.11; 95% confidence interval (CI) 2.03–8.32),
Major depressive episode(MDE) diagnosis (AOR 3.83; CI 1.99–7.31),
multigravidity(AOR 2.87; CI 1.17–7.07), food insecurity (AOR 2.57; CI 1.48–4.46), unplanned and unwanted pregnancy (AOR 2.14; CI 1.11–4.15), pregnancy loss (AOR 2.10; CI 1.19–3.75) and experience of threatening life events (AOR 1.30; CI 1.04–1.57). Increased perceived social support appeared to reduce the risk for antenatal
anxiety(AOR 0.95; CI 0.91–0.99). A range of antenatal
anxiety disordersare prevalent amongst pregnant women living in low-resource settings. Women who experience psychosocial adversity may be exposed to multiple risk factors, which render them vulnerable to developing antenatal
anxiety disorders.
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