Unique trajectories of anxiety among Chinese-Canadian women across the first postpartum year: A longitudinal cohort study.

BACKGROUND: Our objectives were to identify subtypes of Chinese-Canadian women with unique trajectories of anxiety symptomatology over the first postpartum year, investigate covariates associated with group membership, and determine if mental healthcare utilization varies by group membership.

METHODS: This was a longitudinal cohort study of 570 Chinese immigrant and Canadian-born women in Toronto, Canada with live births in 2010-2014. Covariates were age, immigrant status, income, fatigue, social support, acculturative stress, and depression. Mental healthcare utilization included visits at 4-24 weeks postpartum. Anxiety symptomatology was measured using the State-Trait Anxiety Inventory-State. Growth mixture modeling was used to identify latent classes corresponding to trajectories of anxiety symptomology at 4-52 weeks.

RESULTS: Three groups were identified: "consistently non-anxious" (74%, stable low levels of anxiety), "consistently anxious" (19.5%, clinically meaningful anxiety at baseline and across time), and "anxious-improving" (6.5%, high anxiety at baseline followed by decline). Compared to consistently non-anxious women, consistently anxious women were more likely to report baseline fatigue, depression, and acculturative stress; anxious-improving women were more likely to report baseline fatigue, depression, and history of depression before pregnancy. At 12-24 weeks, 13.8% of anxious-improving women sought mental healthcare compared to 8.6% of consistently-anxious women and 4.7% of non-anxious women (p = .06).

LIMITATIONS: Our sample comprised Chinese immigrant and Canadian-born women; results should be replicated in other groups.

CONCLUSIONS: We identified three subtypes of postpartum anxiety trajectories. These groups of women may respond differently to interventions due to exposure to various combinations of risk factors.