Table 1 Standardized tools for psychosocial factors assessed in the AOB study

Depressive Symptoms

Edinburgh Postnatal Depression Scale (EPDS) [58]

10 item questionnaire. Each item rated on a 4-point Likert scale from 0-3. After reverse scoring for some items, a total score is derived (range 0-30). Higher scores reflect increased depressive symptoms. Standard cut-off for risk of major depression as per the literature: 13 and above.

x

x

x

Anxiety

State-Trait Anxiety Inventory (state anxiety scale; SAI) [59]

20 item questionnaire. Each item rated on a 4-point Likert scale from 1-4. After reverse scoring for some items, a total score is derived (range 20-80). Higher scores reflect increased anxiety symptoms. We used an established cut-off of 40 or more to classify women as anxious.

x

x

x

Stress

Perceived Stress Scale (PSS) [60]

10 item questionnaire. Each item rated on a 5-point Likert scale from 0-4. After reverse scoring for some items, a total score is derived (range 0-40). Higher scores reflect increased stress symptoms. A cut-off at the 80^th percentile of the sample distribution was used to classify women as stressed.

x

x

x

Social Support

Medical Outcomes Study (MOS) Social Support Scale [61]

19 item questionnaire. Each item rated on a 5-point Likert scale from 1-5. Scoring algorithms derive subscale scores and a total score (range 0-100). Higher scores reflect increased perception of social support. We used an established cut-off of 69 or less to classify women as having low perceived social support.

x

x

x