From Pregnancy to Postpartum: The Role of Maternal Anxiety and Depression in Breastfeeding Duration and Exclusivity After High- and Low-Risk Pregnancies
Research Laboratory of Midwifery Care During Antenatal and Post Natal Period-Breastfeeding, Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece
*
Author to whom correspondence should be addressed.
Psychiatry Int. 2025, 6(4), 123; https://doi.org/10.3390/psychiatryint6040123
Submission received: 7 July 2025
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Revised: 14 August 2025
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Accepted: 9 October 2025
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Published: 13 October 2025
Abstract
This study investigated the impact of maternal psychological factors—specifically anxiety and depression—on breastfeeding outcomes in women with high-risk and low-risk pregnancies. A total of 157 postpartum women were assessed using the State-Trait Anxiety Inventory (STAI) and the Edinburgh Postnatal Depression Scale (EPDS) at multiple time points: 3–4 days, 3 months, and 6 months postpartum. Breastfeeding duration and exclusivity were the primary outcomes. Correlation analyses showed significant negative associations between STAI scores and breastfeeding duration in both groups, with stronger effects in the low-risk group (e.g., r = −0.546, p < 0.001 at 3 months). Similarly, EPDS scores were inversely correlated with breastfeeding duration, particularly at 3 and 6 months postpartum (r = −0.272, p < 0.001 and r = −0.248, p = 0.001, respectively, in the high-risk group). Logistic regression identified EPDS scores at 3 months (p = 0.046, Exp(B) = 0.844) and STAI scores at 3–4 days postpartum (p = 0.006, Exp(B) = 0.861) as significant predictors of early breastfeeding cessation. The model explained 64.9% of the variance in the low-risk group. These findings highlight the significant influence of postpartum anxiety and depressive symptoms on breastfeeding outcomes and suggest that early screening and support for these specific psychological factors may enhance breastfeeding duration and exclusivity, particularly after high-risk pregnancies.
1. Introduction
Breastfeeding is a vital public health intervention with well-established benefits for both mother and child. Exclusive breastfeeding for the first six months, followed by continued breastfeeding with complementary feeding up to two years or beyond, is endorsed by the World Health Organization [1]. Benefits include reduced risks of infections, SIDS, obesity, and chronic conditions in infants, as well as maternal protection against breast and ovarian cancer, type 2 diabetes, and postpartum hemorrhage [2,3]. Despite these advantages, global breastfeeding rates remain suboptimal, with early cessation and low exclusivity persisting in both high- and low-income settings [4]. Breastfeeding outcomes are shaped by biological, psychological, sociocultural, and structural factors. Among these, maternal mental health during the perinatal period plays a crucial role in influencing breastfeeding behavior, especially its duration and exclusivity [5,6]. This period is marked by emotional vulnerability due to hormonal changes and psychosocial adaptations to the maternal role [7,8].
Anxiety and depressive symptoms during pregnancy and postpartum have been consistently associated with early breastfeeding discontinuation [9,10,11]. Such mood disturbances can impair maternal–infant bonding, reduce self-efficacy, disrupt oxytocin-mediated milk let-down, and undermine feeding routines. Even mothers with positive breastfeeding intentions may face challenges when experiencing depressive symptoms [12,13]. In high-risk pregnancies, complications such as gestational diabetes, preeclampsia, fetal growth restriction, or preterm labor add further physiological and psychological stress, increasing the risk of mood disorders [14,15,16]. These challenges may persist postpartum, disrupting maternal–infant interactions and leading to shorter or less exclusive breastfeeding trajectories.
Even in low-risk pregnancies, perinatal anxiety or depression remains a significant threat to breastfeeding success. Therefore, psychological functioning and obstetric risk status should be seen as interacting, not separate, determinants of breastfeeding outcomes. Beyond individual pathology, social and institutional factors—such as support networks, hospital practices, and prior experience—also influence breastfeeding [17,18]. However, maternal psychological resilience or distress mediates the extent to which these facilitators are effective [19]. Anxiety may lead to misreading of infant cues, while depression may cause ambivalence or disengagement, both of which undermine sustained breastfeeding [11,20].
Breastfeeding reflects not only behavior but also maternal psychosocial adaptation. Emotional availability, caregiving motivation, and sensitivity to infant needs—all shaped by affective states—are central to breastfeeding success. Disruptions in psychological well-being may compromise outcomes even when motivation is initially strong. Although prior research has examined perinatal mental health and obstetric complications independently, fewer studies have explored their interaction in shaping breastfeeding duration and exclusivity. This gap is clinically important, as early identification of at-risk mothers could inform targeted interventions [11,14,15,16].
The aim of this study is to explore the impact of maternal anxiety and depressive symptoms, both during pregnancy and postpartum, on breastfeeding exclusivity and duration up to six months postpartum, with a specific comparison between high-risk and low-risk pregnancies.
2. Materials and Methods
2.1. Study Design
This was a prospective cohort study conducted at a major public hospital—“Alexandra” General Hospital—in Attica, Greece, from May 2020 to January 2022. The primary objective was to investigate the impact of maternal anxiety and depressive symptoms, both antenatal and postnatal, on breastfeeding outcomes, particularly in terms of exclusivity and duration, following high- and low-risk pregnancies. The hospital was selected for its capacity to manage a large volume of both routine and high-risk pregnancies, thus providing an optimal setting for comparative analysis.
2.2. Participants and Eligibility Criteria
Participants were recruited using a convenience sampling method from both the high-risk pregnancy unit and the routine antenatal outpatient clinic. Inclusion criteria required women to be at least 18 years old, fluent in Greek, capable of providing informed consent, and to have delivered a live singleton infant at or beyond 32 weeks of gestation. Exclusion criteria included multiple pregnancies, inability to complete follow-up, perinatal loss, or any condition precluding active breastfeeding. High-risk pregnancy was defined by clinical conditions requiring hospitalization for over 48 h, including but not limited to gestational diabetes, hypertension, preeclampsia, intrauterine growth restriction, and systemic maternal diseases. Low-risk pregnancies were characterized by the absence of these complications and were managed through standard outpatient prenatal care.
From an initial pool of 318 eligible participants, a final cohort of 157 women was analyzed—comprising 59 high-risk and 98 low-risk pregnancies—based on initiation and continuation of breastfeeding post-discharge. Of the 318 initially eligible participants, 161 were excluded due to non-initiation of breastfeeding postpartum, inability to complete follow-up, or clinical conditions such as neonatal loss or NICU admission that precluded inclusion. High-risk pregnancies were defined by clinical conditions requiring hospitalization for over 48 h, including gestational diabetes, preeclampsia, fetal growth restriction, and systemic maternal diseases. These criteria align with national obstetric risk guidelines.
2.3. Data Collection Procedure
Data collection was organized into five phases, designed to span the perinatal and early postpartum period:
Phase 1 (Third trimester): Participants completed a baseline demographic and obstetric questionnaire, alongside psychological assessments (STAI-Trait, STAI-State, and EPDS) during antenatal hospitalization or clinic visits.
Phase 2 (3rd–4th day postpartum): During hospitalization in the maternity ward, mothers were reassessed using the STAI-State scale and EPDS. Information on initial infant feeding practices—categorized as exclusive or mixed—was also collected.
Phase 3 (End of puerperium, ~6 weeks): Follow-up was conducted via phone or online questionnaire. Breastfeeding status and psychological assessments (STAI-State and EPDS) were recorded.
Phase 4 (3 months postpartum): Mothers were contacted by telephone or completed online forms to report breastfeeding type and complete the same psychological assessments.
Phase 5 (6 months postpartum): The final follow-up captured long-term breastfeeding outcomes and maternal psychological status using the same instruments.
Data were collected either in-person, via telephone interviews, or through secure digital platforms (e.g., Google Forms), allowing flexibility and compliance during the COVID-19 pandemic.
2.4. Classification of Breastfeeding Practices
Breastfeeding status was categorized as either exclusive breastfeeding or mixed feeding. Exclusive breastfeeding was defined according to the World Health Organization (WHO) criteria: feeding the infant only breast milk without any supplemental liquids or solids, except for prescribed drops or syrups. Mixed feeding included any combination of breast milk with infant formula or the introduction of solids prior to six months.
2.5. Psychometric Assessment Tools
Sociodemographic information was collected using a structured questionnaire developed by the research team, including variables such as age, marital status, residence, education, employment, and nationality. Two validated psychometric instruments were used to assess maternal mental health:
State-Trait Anxiety Inventory (STAI): This tool evaluates both state anxiety (temporary condition) and trait anxiety (general tendency to be anxious). The STAI consists of two 20-item subscales and has been validated for use in the Greek population. Cronbach’s alpha coefficients for the STAI ranged from 0.91 to 0.94 across phases, indicating high internal consistency.
Edinburgh Postnatal Depression Scale (EPDS): This 10-item self-report questionnaire was employed to screen for depressive symptoms during the perinatal period. The Greek version of the EPDS has demonstrated strong psychometric properties, with established cut-off scores for minor (≥9) and major depression (≥13). Cronbach’s alpha coefficients for the EPDS in this study ranged from 0.85 to 0.90, confirming its reliability.
Both instruments were administered at each study phase to track changes in maternal psychological status and examine potential correlations with breastfeeding outcomes.
2.6. Ethical Considerations
The study was conducted in accordance with the Declaration of Helsinki and received ethical approval from the “Alexandra” General Hospital’s Institutional Review Board (Protocol No. 346, 20 May 2020). All participants were informed about the purpose, procedures, risks, and benefits of the study and provided written informed consent prior to participation. Confidentiality was strictly maintained by anonymizing all data and restricting access to authorized personnel only.
2.7. Statistical Analysis
Data were analyzed using IBM SPSS Statistics for Windows, Version 22.0 (IBM Corp., Armonk, NY, USA). Prior to all inferential analyses, the distribution of continuous variables was assessed using the Kolmogorov–Smirnov and Shapiro–Wilk tests. Based on the results, parametric or non-parametric tests were applied accordingly. Descriptive statistics, including means and standard deviations (SD) for continuous variables and frequencies with percentages for categorical variables, were used to summarize participant demographics and clinical characteristics. Pearson’s correlation coefficients were used to examine associations between psychological scores (STAI, EPDS) and breastfeeding outcomes (duration and exclusivity). Group comparisons between high- and low-risk pregnancies were conducted using independent-samples t-tests for normally distributed continuous variables and Mann–Whitney U tests for non-normally distributed variables. Chi-square (χ2) tests were used to compare categorical variables. Binary logistic regression analysis was performed to identify psychological predictors of breastfeeding duration (≥6 months). Variables with statistically significant bivariate associations were entered into the regression model. The strength of associations was expressed as odds ratios (Exp(B)) with 95% confidence intervals (CI), and model fit was assessed using Nagelkerke’s R2. A two-sided p-value of <0.05 was considered statistically significant.
3. Results
The results of the present study provide a comprehensive overview of the sociodemographic, medical, and psychological factors associated with breastfeeding outcomes, highlighting significant associations between maternal anxiety and depression symptoms and both the duration and exclusivity of breastfeeding in women with high-risk and low-risk pregnancies. Table 1 summarizes the sociodemographic characteristics of the study population. The mean maternal age was higher among women with high-risk pregnancies (33.75 ± 5.48 years) compared to those with low-risk pregnancies (31.69 ± 6.00 years), suggesting that high-risk pregnancies are more prevalent in older maternal age groups. Most participants in both groups were married and residing in urban areas. The majority were of Greek nationality. Educational attainment and employment distribution were similar between groups, with a large proportion having completed tertiary education. These comparable demographic distributions across the groups provided a balanced context for evaluating breastfeeding outcomes.
Table 2 presents the correlations between maternal anxiety, as assessed by the State-Trait Anxiety Inventory (STAI-State), and breastfeeding outcomes across four postpartum time points. In the high-risk group, anxiety on the 3rd–4th postpartum day negatively correlated with breastfeeding duration (r = −0.165, p = 0.035). This trend persisted through 6 months, with significant associations between higher anxiety and shorter duration (r = −0.206, p = 0.008). A similar but stronger pattern was observed in the low-risk group, where anxiety at all time points—including day 3–4 (r = −0.257, p = 0.001), 3 months (r = −0.546, p = 0.000), and 6 months postpartum (r = −0.443, p = 0.000)—significantly predicted reduced breastfeeding duration. Notably, higher anxiety levels were paradoxically associated with increased exclusivity at later stages, possibly reflecting compensatory behaviors among more anxious mothers.
Table 3 summarizes the relationship between depressive symptoms, assessed by the Edinburgh Postnatal Depression Scale (EPDS), and breastfeeding outcomes. Among high-risk pregnancies, higher EPDS scores at 3–4 days postpartum were linked to shorter breastfeeding duration (r = −0.186, p = 0.017). This negative correlation was more pronounced at 3 months (r = −0.272, p < 0.001) and 6 months postpartum (r = −0.248, p = 0.001). Similar trends were noted in the low-risk group, where depressive symptoms had a consistent inverse association with duration at all time points. Moreover, EPDS scores were positively correlated with breastfeeding success (defined as duration and exclusivity) in both groups, possibly indicating that continued breastfeeding among depressed mothers required significant resilience and effort, qualifying as a form of “success” despite emotional strain.
A significant association was identified between the type of feeding on the first postpartum day and NICU admission (Fisher’s Exact Test, p = 0.005) (Table 4). Newborns who were formula-fed showed the highest rates of NICU admission, whereas those who received exclusive or mixed breastfeeding had markedly fewer admissions. Furthermore, formula feeding was associated with notably longer maternal hospitalization (mean range: 11.9 to 17.2 days), in contrast to the shorter stays observed among breastfeeding mothers (Table 4).
Table 5 presents the results of logistic regression analyses examining maternal anxiety (STAI) and depression (EPDS) scores of total breastfeeding duration (defined as ≥6 months). In the high-risk group, EPDS scores at 3 months postpartum were significant predictors of shorter breastfeeding duration (p = 0.046, Exp(B) = 0.844). The model explained 37.5% of the variance in breastfeeding outcomes. In the low-risk group, both STAI and EPDS scores during pregnancy and early postpartum were significant predictors. Higher anxiety levels during late pregnancy (p = 0.050, Exp(B) = 1.109) and at 3–4 days postpartum (p = 0.006, Exp(B) = 0.861) were associated with shorter breastfeeding duration. Likewise, EPDS scores at 3–4 days (p = 0.019, Exp(B) = 1.333), end of puerperium (p = 0.009, Exp(B) = 0.751), and 6 months postpartum (p = 0.003, Exp(B) = 0.683) significantly predicted reduced duration. The model accounted for 64.9% of the variance in the low-risk group.
4. Discussion
The present study contributes robust empirical evidence to the growing literature on the psychological determinants of breastfeeding outcomes, particularly in the context of high-risk pregnancies. Drawing upon a multidimensional theoretical framework that integrates perinatal mental health, maternal behavior, and infant-care dynamics, the results underscore the complex interplay between maternal anxiety, depression, and breastfeeding patterns in the early postpartum period. Importantly, the study’s findings align with and extend current knowledge, providing insights with both clinical and public health implications.
A consistent pattern emerged across the findings, wherein maternal anxiety—particularly state anxiety measured via the STAI-State—exhibited a significant negative correlation with the duration of breastfeeding. This association was evident in both high- and low-risk groups, albeit with greater magnitude and consistency in the low-risk cohort. These results resonate with earlier studies [21,22], which demonstrated that heightened anxiety during the perinatal period compromises lactation outcomes, often via disruptions in oxytocin-mediated let-down reflexes and reduced maternal self-efficacy. Moreover, the paradoxical association observed in our study between higher anxiety and increased breastfeeding exclusivity at later stages may reflect a compensatory behavioral mechanism, whereby anxious mothers adhere more rigidly to breastfeeding guidelines in an effort to mitigate perceived maternal inadequacies—a hypothesis previously suggested by Woolhouse et al. [23].
Depressive symptomatology, as measured by the EPDS, also emerged as a significant predictor of reduced breastfeeding duration, particularly at 3 and 6 months postpartum. These findings are consonant with the extant literature, including studies by Borra et al. [24], Gagliardi et al. [25], and Boone et al. [26], which delineate the detrimental effects of maternal depression on breastfeeding behaviors. Depression can undermine maternal–infant bonding, attenuate motivation, and exacerbate perceptions of breastfeeding as burdensome, thereby contributing to premature cessation. Our logistic regression analysis further identified EPDS scores at multiple time points as independent predictors of early weaning, underscoring the temporally dynamic nature of postpartum affective disturbances.
Although not assessed directly in the present dataset, extensive literature substantiates the mediating role of maternal–infant bonding in breastfeeding success. Chrzan-Dętkoś et al. [27] and Dennis & McQueen [28] reported that impaired bonding significantly increases the likelihood of mixed or formula feeding. The robust correlations observed in our study between bonding difficulties and diminished breastfeeding outcomes provide indirect support for this association. These findings highlight the necessity of comprehensive perinatal interventions that address both affective symptoms and relational processes.
Another salient dimension emerging from our analysis is the differential influence of hospitalization duration and NICU admission on breastfeeding intentions and behaviors. Women experiencing prolonged antenatal hospitalization (in high-risk pregnancies), often exhibit elevated anxiety levels that hinder breastfeeding initiation [29]. Conversely, moderate-duration hospitalization may foster a structured and supportive environment that facilitates maternal recovery and encourages exclusive breastfeeding. This duality underscores the need to differentiate between clinically supportive and psychologically disruptive hospitalization experiences.
In line with WHO recommendations, our findings reinforce the centrality of maternal psychological well-being in breastfeeding promotion strategies [30]. The integration of psychological screening tools like the STAI and EPDS into routine prenatal care could enable early identification of at-risk women, enabling timely psychotherapeutic or psychosocial interventions. Interventions such as cognitive behavioral therapy (CBT), mindfulness-based stress reduction (MBSR), and targeted lactation counseling have been shown to improve both maternal mood and breastfeeding adherence [31,32].
Interestingly, the timing of the maternal decision to breastfeed was also influential: women who decided prenatally to breastfeed demonstrated consistently higher exclusivity and duration. This finding aligns with those of Rempel [33] and Forster & McLachlan [34], who identified prenatal intention as a robust predictor of breastfeeding commitment, mediated by maternal confidence and perceived support. Education and early decision-making appear especially crucial for women facing high-risk pregnancies, whose medical trajectories may complicate breastfeeding.
It is also critical to consider how medical complications, such as preterm birth and NICU admission, intersect with maternal mental health and breastfeeding behavior. Studies by Brownell et al. [19], Zakarija-Grković et al. [35], and Ikonen et al. [36] document the cascading effects of delayed breastfeeding initiation, diminished skin-to-skin contact, and reliance on expressed milk over direct breastfeeding. These disruptions are often magnified in mothers with high state anxiety or depressive symptoms, reinforcing the bidirectional relationship between maternal mental health and breastfeeding capacity.
Notably, our results indicate that psychological distress is not merely a correlate but may serve as a modifiable determinant of breastfeeding behavior. The predictive power of antenatal and early postpartum EPDS and STAI scores in the logistic regression models reinforces this notion. Moreover, these results call for a paradigm shift in perinatal care, moving from reactive to preventive models that incorporate mental health as a foundational element of maternal–infant care.
Despite the strength of our methodology, several limitations must be acknowledged. First, although we included standardized psychometric instruments, our reliance on self-report measures may introduce social desirability bias or inaccuracies due to recall. Second, while the study employed a longitudinal design, some attrition occurred, particularly in the 6-month follow-up, potentially affecting the generalizability of later findings. Additionally, although the sample was demographically diverse in terms of education and residence, it was geographically limited, and results may not generalize to other sociocultural contexts.
Future research should incorporate more diverse populations, use observational assessments alongside self-report tools, and evaluate the efficacy of targeted psychological and breastfeeding interventions in randomized controlled trials. Importantly, interdisciplinary collaboration between midwives, obstetricians, pediatricians, psychologists, and others professionals is essential to operationalize the findings into effective clinical practice.
5. Conclusions
This study highlights the significant impact of maternal psychological factors—particularly anxiety and depression—on breastfeeding duration and exclusivity, with stronger effects observed among women after high-risk pregnancies. These findings emphasize the importance of early identification and support for maternal mental health as a key strategy to promote successful breastfeeding. Integrating mental health screening and support into perinatal care, especially for high-risk groups, may enhance breastfeeding outcomes and overall maternal–infant well-being. Future research should further explore these associations using longitudinal methods and investigate the role of broader social and healthcare determinants.
Author Contributions
Methodology, M.D. and P.B.; software, P.B.; investigation, P.B., E.T., A.K. and S.L.; writing—original draft preparation, M.D. and P.B.; writing—review and editing, M.D.; supervision, M.D.; project administration, P.B. and M.D. All authors have read and agreed to the published version of the manuscript.
Funding
This research received no external funding.
Institutional Review Board Statement
The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the “Alexandra” General Hospital’s Institutional Review Board (Approval code: 346; Approval date: 26 May 2020).
Informed Consent Statement
Informed consent was obtained from all subjects involved in the study.
Data Availability Statement
The data presented in this study are available on request from the corresponding author due to ethical approval requirements.
Conflicts of Interest
The authors declare no conflicts of interest.
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Table 1.
Sociodemographic characteristics of participants.
| Variable | High-Risk Pregnancy (n = 164) | Low-Risk Pregnancy (n = 154) | p-Value |
|---|---|---|---|
| Age (mean ± SD) | 33.75 ± 5.48 | 31.69 ± 6.00 | 0.002 * |
| Marital Status | 0.161 | ||
| 146 (89.0%) | 145 (94.2%) | |
| 16 (9.8%) | 9 (5.8%) | |
| 2 (1.2%) | 0 (0.0%) | |
| Place of Residence | 0.221 | ||
| 127 (77.4%) | 131 (85.1%) | |
| 26 (15.9%) | 16 (10.4%) | |
| 11 (6.7%) | 7 (4.5%) | |
| Nationality | 0.071 | ||
| 152 (92.7%) | 135 (87.7%) | |
| 5 (3.0%) | 14 (9.1%) | |
| 7 (4.3%) | 5 (3.2%) | |
| Maternal Education Level | 0.165 | ||
| 17 (10.4%) | 6 (3.9%) | |
| 51 (31.1%) | 53 (34.4%) | |
| 73 (44.5%) | 74 (48.1%) | |
| 23 (14.0%) | 21 (13.6%) | |
| Partner’s Education Level | 0.778 | ||
| 18 (11.0%) | 13 (8.4%) | |
| 72 (43.9%) | 64 (41.6%) | |
| 59 (36.0%) | 60 (39.0%) | |
| 15 (9.1%) | 17 (11.0%) |
*: p < 0.005.
Table 2.
Correlation between maternal anxiety (STAI-State) and breastfeeding outcomes at four postpartum time points.
Table 2.
Correlation between maternal anxiety (STAI-State) and breastfeeding outcomes at four postpartum time points.
| Time Point | Risk Group | STAI-State vs. Breastfeeding Duration (r, p) | STAI-State vs. Exclusive Breastfeeding (r, p) |
|---|---|---|---|
| 3rd–4th Postpartum Day | High-Risk | −0.165, p = 0.035 | 0.081, p = 0.305 |
| Low-Risk | −0.257, p = 0.001 | 0.265, p = 0.001 | |
| End of Puerperium | High-Risk | −0.405, p = 0.068 | −0.030, p = 0.896 |
| Low-Risk | −0.044, p = 0.851 | 0.015, p = 0.949 | |
| 3 Months Postpartum | High-Risk | −0.250, p = 0.001 | 0.438, p = 0.000 |
| Low-Risk | −0.546, p = 0.000 | 0.548, p = 0.000 | |
| 6 Months Postpartum | High-Risk | −0.206, p = 0.008 | 0.418, p = 0.000 |
| Low-Risk | −0.443, p = 0.000 | 0.506, p = 0.000 |
Table 3.
Correlation between maternal depression (EPDS scores) and breastfeeding outcomes at four postpartum time points.
Table 3.
Correlation between maternal depression (EPDS scores) and breastfeeding outcomes at four postpartum time points.
| Time Point | Risk Group | EPDS vs. Breastfeeding Duration (r, p) | EPDS vs. Breastfeeding Success (r, p) |
|---|---|---|---|
| 3rd–4th Postpartum Day | High-Risk | −0.186, p = 0.017 | 0.025, p = 0.753 |
| Low-Risk | −0.238, p = 0.003 | 0.197, p = 0.015 | |
| End of Puerperium | High-Risk | −0.306, p < 0.001 | 0.333, p < 0.001 |
| Low-Risk | −0.607, p < 0.001 | 0.651, p < 0.001 | |
| 3 Months Postpartum | High-Risk | −0.272, p < 0.001 | 0.510, p < 0.001 |
| Low-Risk | −0.535, p < 0.001 | 0.608, p < 0.001 | |
| 6 Months Postpartum | High-Risk | −0.248, p = 0.001 | 0.465, p < 0.001 |
| Low-Risk | −0.593, p < 0.001 | 0.596, p < 0.001 |
Table 4.
Association between feeding type on 1st postpartum day, NICU admission, and maternal hospitalization duration in high-risk pregnancies.
Table 4.
Association between feeding type on 1st postpartum day, NICU admission, and maternal hospitalization duration in high-risk pregnancies.
| Feeding Type (1st 24 h) | NICU Admission (n) | Fisher’s Exact Test (p) | Mean Days of Maternal Hospitalization |
|---|---|---|---|
| Exclusive Breastfeeding | 1/19 | p = 0.005 | 4.0–4.5–5.7 |
| Mixed Feeding | 1/62 | 4.0–4.5–5.2 | |
| Formula Feeding | 9/50 | 11.9–13.5–17.2–14.4 |
Note: NICU = Neonatal Intensive Care Unit; Data refer to high-risk pregnancies only. Values represent absolute counts (Yes/No) or mean days across hospitalization ranges.
Table 5.
Logistic regression analysis: psychological predictors of breastfeeding duration (≥6 months).
Table 5.
Logistic regression analysis: psychological predictors of breastfeeding duration (≥6 months).
| Predictor Variable | B | S.E. | p-Value | Exp(B) | R2 |
|---|---|---|---|---|---|
| High-Risk Group | 0.375 | ||||
| EPDS at 3 Months Postpartum | −0.170 | 0.085 | 0.046 | 0.844 | |
| Low-Risk Group | 0.649 | ||||
| STAI-State in Late Pregnancy (≥32 weeks) | 0.104 | 0.053 | 0.050 | 1.109 | |
| STAI-State at 3–4 Days Postpartum | −0.150 | 0.055 | 0.006 | 0.861 | |
| EPDS at 3–4 Days Postpartum | 0.287 | 0.122 | 0.019 | 1.333 | |
| EPDS at End of Puerperium | −0.286 | 0.110 | 0.009 | 0.751 | |
| EPDS at 6 Months Postpartum | −0.381 | 0.128 | 0.003 | 0.683 |
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Dagla, M.; Brani, P.; Tomara, E.; Kokkinari, A.; Louverdi, S. From Pregnancy to Postpartum: The Role of Maternal Anxiety and Depression in Breastfeeding Duration and Exclusivity After High- and Low-Risk Pregnancies. Psychiatry Int. 2025, 6, 123. https://doi.org/10.3390/psychiatryint6040123
AMA Style
Dagla M, Brani P, Tomara E, Kokkinari A, Louverdi S. From Pregnancy to Postpartum: The Role of Maternal Anxiety and Depression in Breastfeeding Duration and Exclusivity After High- and Low-Risk Pregnancies. Psychiatry International. 2025; 6(4):123. https://doi.org/10.3390/psychiatryint6040123
Chicago/Turabian StyleDagla, Maria, Panagiota Brani, Eirini Tomara, Artemisia Kokkinari, and Sevasti Louverdi. 2025. "From Pregnancy to Postpartum: The Role of Maternal Anxiety and Depression in Breastfeeding Duration and Exclusivity After High- and Low-Risk Pregnancies" Psychiatry International 6, no. 4: 123. https://doi.org/10.3390/psychiatryint6040123
APA StyleDagla, M., Brani, P., Tomara, E., Kokkinari, A., & Louverdi, S. (2025). From Pregnancy to Postpartum: The Role of Maternal Anxiety and Depression in Breastfeeding Duration and Exclusivity After High- and Low-Risk Pregnancies. Psychiatry International, 6(4), 123. https://doi.org/10.3390/psychiatryint6040123
