Maternal perinatal anxiety and infant primary care use in 1998-2016: a UK cohort study.

BACKGROUND

There is some evidence that perinatal anxiety (PNA) is associated with lower rates of infant vaccinations and decreased access to preventative infant healthcare, but results across studies have not been conclusive.

OBJECTIVE

To investigate the relationship between maternal PNA and infant primary care use.

METHODS

Cohort study of mother-infant pairs identified between 1998 and 2016 using IQVIA Medical Research Database (IMRD). PNA was identified through prescription, diagnosis and symptom records from start of pregnancy up to 1 year after birth. Outcomes include primary care consultation rate, attendance at the 6-8 week infant check and uptake of the infant 5-in-1 vaccination, comparing unadjusted rates of consultations and using logistic regression to analyse other outcomes.

FINDINGS

Of the 248 618 women, 11 558 (4.7%) had a record of PNA. Infants of mothers with PNA had, on average, one more primary care consultation/person-year compared with those without (9.7 vs 8.7) in the year after birth. Mothers with PNA were more likely to have an infant who was vaccinated (adjusted OR (aOR) 1.33, 95% CI 1.20 to 1.48) but were less likely to have a record of attendance at the 6-8 week infant check (aOR 0.88, 95% CI 0.81 to 0.95).

CONCLUSIONS

Infants of mothers with PNA had, on average, a slightly higher rate of primary care consultations and were more likely to be vaccinated but less likely to have a record of an infant check.

CLINICAL IMPLICATIONS

Midwives and General Practitioners (GPs) providing care should consider how PNA may impact on infant health and how infant health may impact on maternal anxiety.