The study was based on information from more than 50 000 pregnant women who participates in the ongoing Norwegian Mother and Child Cohort Study (MoBa), conducted at the Norwegian Institute of Public Health.

Relationship satisfaction most important

The study shows that low satisfaction with the partner relationship was the most important risk factor for anxiety or depression symptoms in pregnancy. 

"Of all the 37 factors we examined, relationship dissatisfaction was the main predictor for anxiety or depression during pregnancy," says Gun-Mette B. Røsand from the Division of Mental Health at the Norwegian Institute of Public Health. Røsand is specialised in clinical psychology and will defend her doctoral thesis in psychology in April. 

The current results confirm findings from previous research. However, most previous studies on anxiety and depression in pregnancy have been fairly small compared to this study. “The large sample size is quite unique, therefore our results give relatively precise information on the relative effects of the different risk factors,” said Røsand, who is not aware of other studies of anxiety and depression in pregnancy that investigate such a large number of predictors simultaneously.

Good relationship “buffers”

The study shows that good partner relationships seemed to act as a "buffer" against adverse effect of stressors such as physical illness, low income and difficult working conditions. 

“This means that women who have a good partner relationship will be able to cope with more stress in other areas without becoming anxious and depressed, compared with women who are dissatisfied with their relationship," said Røsand. 

“Knowledge about the importance of partner relationship quality for maternal mental health in pregnancy could to a greater extent be integrated in the antenatal care of pregnant women. When treating a pregnant woman for anxiety and depression the partner should be involved to a certain degree to build and strengthen partner support. Previous research has shown that maternal mental health during pregnancy is important for the child's physical and psychological health and the welfare of the family," said Røsand.

About the study

The study examined a set of risk and protective factors for anxiety and depression symptoms in women at week 17 of pregnancy. A particular focus was on factors related to the partner, family, and organizing everyday life. The study also examined whether a good relationship can protect against adverse effects of various stressors. 

The results cannot be used to calculate the number of women who suffer from anxiety and depression since anxiety and depression were measured along a continuous scale. From previous research we know that the prevalence rate for anxiety and depression in pregnancy varies between 5-15 per cent, depending on definition, population and time of measurement. 

The study uses information from more than 50 000 pregnant women participating in the Norwegian Mother and Child Cohort Study, conducted at the Norwegian Institute of Public Health. The participants completed a general health questionnaire in week 17 of pregnancy. 

The outcome variable is anxiety and depression symptoms. The study shows the relative importance of 37 risk and protective factors, among which are: 

• Socio-demographic factors: age, single status, family income, employment status of the women and their partners, unemployment among the women and their partners and education level of the women and their partners. 
• Social network and family: the degree of satisfaction with the relationship, social support from friends and family, family organisation (whether they live with extended family, nuclear family or others).
• Daily strain: work related stress and strain, the woman’s sick leave, children without nursery care, shift work, type of residence.
• Negative life events: Frequent moving, past and present experiences of violence, past and present sexual abuse of varying severity.
• Lifestyle and health: smoking, alcohol consumption, alcohol problems, physical health. 

Reference:

Partner relationship satisfaction and maternal emotional distress in early pregnancy. Authors: Gun-Mette B. Røsand, Kari Slinning, Malin Eberhard-Gran, Espen Røysamb, Kristian Tambs. Journal: BMC Public Health 2011, 11:161.