BRIEF RESEARCH REPORT article
Front. Psychol.
Sec. Health Psychology
This article is part of the Research TopicPerinatal mental health: Depression, Anxiety, Stress, and FearView all 32 articles
Effects of antenatal education on maternal anxiety and depression in pregnancy and postpartum period in Italy: Modest and transient symptom reductions
Provisionally accepted
- Istituto Superiore di Sanita, Rome, Italy
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Introduction: Antenatal classes have increasingly been integrated into healthcare practices in most middle-and high-income countries over recent decades. The present study aimed to compare levels of anxiety and depressive symptoms during pregnancy and the postpartum period among (a) women who attended antenatal classes and (b) women who did not participate in antenatal education. Methods: We analyzed 9,689 perinatal respondents recruited in eight Italian regions between October 2021 and December 2024. Each participant was assessed once, during their pregnancy (n=4,169) or their postpartum period (n=5,520), and completed the General Anxiety Disorder-7 (GAD-7) and Edinburgh Postnatal Depression Scale (EPDS) scales. The cut-off scores to identify women at risk for depression and anxiety were ≥12 and ≥10 for EPDS and GAD-7, respectively. Propensity scores based on socio-demographic and clinical covariates were estimated with multiple imputations and inverse-probability-of-treatment weighting (IPTW). Results: Attendance was frequent (47%). Crude models showed that, during pregnancy, class participants had lower mean scores (ΔGAD=–0.8; ΔEPDS=–1.0) and markedly lower odds of screening positive (OR=0.58 for anxiety; 0.45 for depression). After IPTW adjustment these associations weakened and became non-significant (pregnancy OR=0.86, 95%CI 0.54–1.35 for anxiety; 0.64, 0.38–1.10 for depression); all post-partum IPTW estimates were similarly null (ORs 0.96 and 0.83, CIs span 1). E-values (1.9–2.5) indicated that moderate unmeasured confounding could erase the residual pregnancy effects. Conclusions: Our results suggest antenatal education classes are modestly effective in reducing anxiety and depressive symptoms during pregnancy. However, these modest prenatal improvements attenuate after adjustment and do not persist into the postpartum period.
Keywords: Anxiety, Childbirth classes, Depression, Expectant parent classes, Prenatal Education
Received: 13 Oct 2025; Accepted: 02 Dec 2025.
Copyright: © 2025 Stefana, Mirabella, Gigantesco, Calamandrei and Camoni. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Alberto Stefana
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.