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Abstract

Background
Few studies have evaluated postnatal anxiety and posttraumatic stress (PTS) before and during the Covid-19 pandemic using comparable data across time. We used data from two national maternity surveys in England to explore the impact of the pandemic on prevalence and risk factors for postnatal anxiety and PTS.

Methods
Analysis was conducted using population-based surveys carried out in 2018 (n = 4509) and 2020 (n = 4611). Weighted prevalence estimates for postnatal anxiety and PTS were compared across surveys. Adjusted risk ratios (aRR) were estimated for the association between risk factors and postnatal anxiety and PTS.

Findings
Prevalence of postnatal anxiety increased from 13.7 % in 2018 to 15.1 % in 2020 (+1.4 %(95%CI:-0.4–3.1)). Prevalence of postnatal PTS increased from 9.7 % in 2018 to 11.5 % in 2020 (+1.8 %(95%CI:0.3–3.4)), due to an increase in PTS related to birth trauma from 2.5 % to 4.3 % (+1.8 %(95%CI:0.9–2.6); there was no increase in PTS related to non-birth trauma. Younger age (aRR = 1.31–1.51), being born in the UK (aRR = 1.29–1.59), long-term physical or mental health problem(s) (aRR = 1.27–1.94), and antenatal anxiety (aRR = 1.97–2.22) were associated with increased risk of postnatal anxiety and PTS before and during the pandemic, whereas higher satisfaction with birth (aRR = 0.92–0.94) and social support (aRR = 0.81–0.82) were associated with decreased risk.

Interpretation
Prevalence of PTS was significantly higher during the pandemic, compared to before the pandemic, due to an increase in PTS related to birth trauma. Prevalence of postnatal anxiety was not significantly higher during the pandemic. Risk factors for anxiety and PTS were similar before and during the pandemic.

Publication Type:	Article
Additional Information:	This article is available under the Creative Commons CC-BY-NC-ND license and permits non-commercial use of the work as published, without adaptation or alteration provided the work is fully attributed.
Publisher Keywords:	Anxiety, Birth trauma, Pandemic, Posttraumatic stress
Departments:	School of Health & Psychological Sciences School of Health & Psychological Sciences > Midwifery & Radiography
SWORD Depositor:	Symplectic Administrator

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