Introduction: Evidence indicates that mothers with postpartum depression have different patterns of healthcare service (HS) use than healthy counterparts; however, less is known regarding maternal anxiety and postpartum HS use. Our study objective was to assess patterns of routine (well-baby and vaccinations) and non-routine (Emergency Department (ED), family physician, walk-in clinic visits; telehealth; and hospital admissions) maternal and infant HS use up to 6 months postpartum, and to determine whether patterns of use differ by maternal anxiety.
Methods: We conducted a secondary analysis of a prospective birth cohort of 446 mothers and their full-term infants, recruited from all active maternity hospitals in Calgary, Alberta, in 2010. Data were collected at delivery, 6 weeks and 6 months postpartum. Sources and frequency of HS use were summarized. Associations between HS use and maternal anxiety (State Anxiety Scale), were identified using logistic regression, accounting for maternal and infant demographic and clinical characteristics.
Results: Approximately 18% of mothers in our sample (N=79 of 446) had anxiety at delivery. Mothers with anxiety had 50%-60% lower odds of attending routine infant HS, including well-baby checks (OR: 0.41, p=0.015) and vaccination appointments (OR: 0.50, p=0.013), compared to mothers without anxiety. No statistically significant differences in the odds of non-routine infant HS use, including ED, family physician and walk-in clinic visits; telehealth utilization; and hospital admissions, were observed. No significant differences were found for routine or non-routine maternal HS use.
Conclusion: Infants of mothers with anxiety may be at higher risk for missing preventive healthcare and health-status monitoring through infancy than those of non-anxious mothers. Larger studies with greater statistical power to detect differences in non-routine HS use, in anxious and non-anxious mothers, and that examine infant health outcomes should be conducted to inform health service planning for the unique healthcare needs of mothers with anxiety.
Katie Chaput– Assistant Professor, Department of Obstetrics and Gynecology, University of Calgary, Calgary, AB
Ada Madubueze– Graduate Student, University of Calgary
Amy Metcalfe– Associate Professor, Department of Obstetrics and Gynecology, University of Calgary, Calgary, AB
Suzanne Tough– Professor, Department of Paediatrics, University of Calgary, Calgary, AB