Coping strategies in women with anxiety and depression during prenatal period

Objective: To determine the frequency and association of coping strategies with  different  levels  of  anxiety and depression. Methods: A cross-sectional study was carried out in private hospitals of Karachi, from January to May 2017. Data was collected from pregnant women willing to participate in the study by using non-probability convenient  sampling.  A  questionnaire  was  used  to  gather  socio-demographic  and  obstetric  data after informed consent  from  pregnant  women.  Hospital  anxiety  and  depression  scale  (HADS)  was used to identify different levels of anxiety and  depression.  Coping  strategies  were  assessed  by using brief inventory results which were assessed on SPSS 16. Results: Study group included 400 women between the ages of 18 to 38 years with a mean age of 27.08 ± 4.074. The adaptive strategies were used  by  23.3%  of  the  study  group.  Maladaptive  strate- gies were adopted by 17.9% of women and 58.9% were using both adaptive and maladaptive strate-      gies. There was a significant association  of  adaptive  strategies  and  women  appearing  normal  on  HADS scale (p-value= 0.000, OR= .077) whereas there was negative association with maladaptive strategies and normal behaviour (p-value= 0.032, OR= 1.747).  Women  with  borderline  anxiety  were  using only combination of both types of strategies. Women using maladaptive strategies were having significant association with abnormal level of anxiety (p-value= 0.000, OR= 3.369) with borderline de- pression (p-value= 0.012, OR= .420) and abnormal depression (p-value= 0.000, OR=  -6.657).  Active coping (OR 5.952 and 6.679), instrumental (OR 4.138 and 6.679), planning (OR 10.300 and 6.646),) and positive reframing (OR 1.735 and 3.765) were protective for abnormal anxiety and abnormal de- pression. Religious practices were protective for abnormal anxiety only (OR= 4.289). Conclusion: Adaptive strategies are associated with normal mental status and are protective for anxiety and depression whereas maladaptive strategies are the risk factors for anxiety and depression.  Pregnant women should be encouraged to adopt adaptive strategies to reduce the adverse outcome associated with anxiety and depression.