Anxiety Disorders During Pregnancy and the Postpartum Period: A Systematic Review. [CME]
J Clin Psychiatry 2006;67(8):1285-1298
© Copyright 2015 Physicians Postgraduate Press, Inc.
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Objective: The postpartum period is recognized
as a time of vulnerability to affective disorders, particularly
postpartum depression. In contrast, the prevalence and clinical
presentation of anxiety disorders during pregnancy and the
postpartum period have received little research attention. In
this article, we review the medical literature as it relates to
the prevalence and clinical presentation of panic disorder,
obsessive-compulsive disorder, posttraumatic stress disorder, and
generalized anxiety disorder during pregnancy and the postpartum
Data Sources: MEDLINE (1966 to July 2005 week 1)
and PsycInfo (1840 to July 2005 week 1) were searched using
combinations of the following search terms: pregnancy,
childbirth, postpartum, panic disorder, phobia,
obsessive-compulsive disorder, posttraumatic stress disorder,
and generalized anxiety disorder.
Study Selection: All relevant papers published
in English and reporting original data related to perinatal
anxiety disorders were included.
Data Extraction: Studies were examined for data
related to the prevalence, presentation, predictors/risk factors,
new onset, course, and treatment of anxiety disorders during
pregnancy and the postpartum period.
Data Synthesis: Anxiety disorders are common
during the perinatal period, with reported rates of
obsessive-compulsive disorder and generalized anxiety disorder
being higher in postpartum women than in the general population.
The perinatal context of anxiety disorders presents unique issues
for detection and management.
Conclusions: Future research is needed to
estimate the prevalence of perinatal anxiety disorders more
precisely, to identify potential implications of maternal anxiety
disorders for maternal quality of life and child development, and
to determine safe and effective treatment methods.