Socioeconomic deprivation and perinatal anxiety: an observational cohort study

Background: Women from areas of social deprivation and minority ethnic groups are more likely to experience poor physical health and have higher rates of mental health problems relative to women from less socially disadvantaged groups. However, very little research has examined this in relation to perinatal anxiety. The current study aims to determine prevalence, risk factors and desire for treatment for perinatal anxiety in three regions of the UK with diverse regional characteristics.

Methods: Women completed measures of anxiety in early, mid-, late-pregnancy and postpartum. Participants were included from three regions of the UK: Region 1 = North East England & North Cumbria n = 512; Region 2 = London North Thames n = 665; Region 3 = West Midlands n = 705.

Results: Prevalence of perinatal anxiety was lower in Region 1 (OR 0.63 95% CI 0.45 to 0.89) and Region 2 (OR 0.72 95% CI 0.52 to 0.98) relative to Region 3. Analysis showed the effect of neighbourhood socioeconomic deprivation on perinatal anxiety differed by region. In more affluent regions, living in a deprived neighbourhood had a greater impact on perinatal anxiety than living in a deprived neighbourhood in a deprived region. Other factors associated with risk of anxiety in the perinatal period included physical health problems and identifying as being from 'mixed or multiple' ethnic groups.

Conclusions: Neighbourhood deprivation relative to regional deprivation is a better predictor of perinatal anxiety than either regional deprivation or neighbourhood deprivation alone. Women of mixed ethnic backgrounds and women with physical health problems may warrant more attention in terms of screening and support for perinatal anxiety. Self-reported desire for treatment was found to be low.