Prevalence and Associated Factors in Nausea and Vomiting Among Pregnant Women in Eastern Ethiopia: A Community-Based Cross-Sectional Study.

Prenatal anxiety is an often-overlooked public health concern with lasting effects on the health and well-being of families. Approximately 20% of prenatal individuals meet the clinical criteria for anxiety, and the adverse impacts are not isolated to pregnancy. Prenatal anxiety has been associated with increased risk of poor physical and mental health outcomes for the mother and baby ( preeclampsia, hemorrhage, fetal death, preterm birth, or a low birthweight). The multigenerational impacts of prenatal anxiety extend beyond birth experience, negatively affecting the development of the child and health care costs for the family. One study on the economic burden of perinatal mood and anxiety disorders (PMADs) from conception to 5 years postpartum estimated that untreated PMADs can cost a mother-child dyad more than $30,000. Because both biological and social determinants of health contribute to the risk and severity of mental health challenges, prenatal anxiety disproportionately impacts women of low socioeconomic status (SES). Unmet psychological needs and systemic inequities such as insufficient access to quality health care, food insecurity, housing- and transportation-related strain, and discrimination influence this disparity. Given that individuals of low SES with prenatal anxiety are more likely to deliver preterm and have adverse prenatal health outcomes, there is a need for effective interventions to buffer associations between adverse social determinants of health ( food insecurity, poverty) and prenatal anxiety in low-income populations. Thus far, literature on the prevalence and treatment of prenatal anxiety is insufficient, with most focusing on prenatal depression or grouping depression and anxiety together as prenatal mood and anxiety disorders. The prevalence and far-reaching effects of prenatal anxiety and the disproportionate impact on vulnerable communities emphasize the critical importance of identifying tailored evidence-based strategies to prevent and treat this mental health disorder. Social support provides a promising strategy to prevent and manage prenatal anxiety due to its strong connection to improved psychological health. It is well established that appropriate social support is associated with lower anxiety and depression. In prenatal individuals specifically, perceived social support has been shown to predict prenatal anxiety, possibly due to its ability to mitigate stress. Similarly, lack of social support is associated with increased risk of prenatal anxiety. In those with low social support, prenatal stress was shown to increase poorer infant temperament, which could further contribute to anxiety risk. In contrast, ample social support and social networks are associated with better labor and infant health outcomes ( babies with higher Apgar scores and birth weight). There is a lack of evidence around the types and sources of social support that are most protective against prenatal anxiety specifically. To effectively leverage social support as a prevention strategy for prenatal anxiety, more research is needed to understand the specific types and sources of social support that are most protective for low-SES prenatal women.