National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK.
School of Nursing and Midwifery, Queens University Belfast, Belfast, Northern Ireland, UK.
BMC Pregnancy Childbirth. 2022 Mar 3;22(1):180. doi: 10.1186/s12884-022-04437-0.
Identifying women with perinatal anxiety is important in order to provide timely support and prevent adverse outcomes. Self-report instruments are commonly used in maternity settings. An alternative is to ask women directly whether they self-identify as having anxiety. We examine the agreement between self-reported and self-identified anxiety at 3 months postpartum and compare the characteristics of women with self-reported and self-identified anxiety.
A secondary analysis of national maternity surveys conducted in 2014 in England and Northern Ireland was conducted. Self-reported anxiety was assessed using the Edinburgh Postnatal Depression Scale anxiety subscale (EPDS-3A). Agreement between self-reported and self-identified anxiety was measured using Cohen's kappa. Logistic regression was used to identify characteristics of women in each group.
In our sample of 6752 women, 14.2% had self-reported anxiety, 5.9% had self-identified anxiety and 3.5% were positive on both measures. Among those with self-identified anxiety, 58.1% also had self-reported anxiety. Of those with self-reported anxiety, 24.4% also had self-identified anxiety. Statistical agreement between the two measures was minimal with Cohen's kappa 0.283 at an EPDS-3A threshold of ≥6. Among both self-identified and self-reported anxiety groups, psychological factors were the strongest associated factors. Women with self-reported anxiety had higher odds of being from Northern Ireland (OR 1.81); having a mixed or unhappy reaction to the pregnancy (OR 1.65); living without a partner (aOR 1.37); and antenatal depression (aOR 1.32). Women with self-identified anxiety had higher odds of physical problems (OR 1.84); and being of Black or minority ethnicity (OR 0.39).
Asking postnatal women directly whether they self-identify as having anxiety identifies a different group of women from those who score highly on self-report measures. Women with self-identified anxiety may benefit from further follow-up and support.
为了提供及时的支持和预防不良后果，识别围产期焦虑的女性很重要。自我报告工具通常用于产科环境。另一种方法是直接询问女性是否自我认同患有焦虑症。我们检查了产后 3 个月时自我报告和自我识别的焦虑之间的一致性，并比较了自我报告和自我识别的焦虑症女性的特征。
对 2014 年在英格兰和北爱尔兰进行的全国产妇调查进行了二次分析。使用爱丁堡产后抑郁量表焦虑分量表（EPDS-3A）评估自我报告的焦虑症。使用 Cohen's kappa 测量自我报告和自我识别的焦虑之间的一致性。使用逻辑回归确定每组女性的特征。
在我们的 6752 名女性样本中，14.2%有自我报告的焦虑症，5.9%有自我识别的焦虑症，3.5%在两种测量方法上均呈阳性。在自我识别的焦虑症患者中，58.1%也有自我报告的焦虑症。在有自我报告的焦虑症患者中，24.4%也有自我识别的焦虑症。两种测量方法之间的统计学一致性很小，EPDS-3A 阈值≥6 时 Cohen's kappa 为 0.283。在自我识别和自我报告的焦虑症组中，心理因素是最强的相关因素。有自我报告的焦虑症的女性更有可能来自北爱尔兰（OR 1.81）；对怀孕有混合或不满意的反应（OR 1.65）；没有伴侣（aOR 1.37）；和产前抑郁症（aOR 1.32）。有自我识别的焦虑症的女性更有可能出现身体问题（OR 1.84）；和黑人或少数族裔（OR 0.39）。
直接询问产后女性是否自我认同患有焦虑症，可从那些自我报告得分较高的女性中识别出另一组女性。自我识别的焦虑症女性可能需要进一步随访和支持。
