Trajectories and Correlates of Anger During the Perinatal Period.

OBJECTIVES

To investigate trajectories of anger during pregnancy and the early postpartum period; to identify baseline psychosocial predictors of anger trajectory group membership; and to examine correlates of anger trajectory group membership, including symptoms of depression, anxiety, insomnia, and social support, in the postpartum period.

DESIGN

Longitudinal descriptive design.

SETTING

We recruited participants from a maternity clinic in Calgary, Alberta, Canada.

PARTICIPANTS

The sample included a convenience sample of 143 pregnant women who had basic fluency in English, were older than 17 years of age, and were less than 19 weeks gestation with a single fetus at the time of recruitment.

METHODS

Participants completed online questionnaires at four time points: early, mid-, and late pregnancy and 2 months after birth. We used group-based semiparametric mixture modeling to estimate patterns of anger. We used multinomial logistic regression to explore associations between baseline predictors and trajectory membership.

RESULTS

We identified four distinct trajectories of anger during pregnancy through 2 months after birth: minimal-stable anger (55%), mild-stable anger (24%), moderate-stable anger (14%), and high-decreasing anger (7%). Membership in the moderate-stable group was associated with greater baseline symptoms of depression, anxiety, and insomnia severity scores compared to the minimal-stable anger group. Moderate-stable trajectory group membership was also associated with greater symptoms of anxiety, depression, and insomnia at 2 months after birth.

CONCLUSION

Higher levels of anger were associated with worse mental health in pregnancy and after childbirth in our participants. Women should be made aware of anger as a possible mood disturbance by clinicians, and researchers should investigate the consequences of anger during the perinatal period.