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1 in 5 women have anxiety disorders in pregnancy, postpartum

Anxiety disorders in pregnancy and the postpartum period were more prevalent than previously believed, with about 1 in 5 women meeting diagnostic criteria for an anxiety disorder, according to results from a multivariate Bayesian meta-analysis.

“Screening and treatment of peripartum [anxiety disorders] are especially important given the potential short- and long-term effects of anxiety on offspring,” Emily Fawcett, PhD, of Memorial University of Newfoundland in Canada, and colleagues wrote in Journal of Clinical Psychiatry. “Knowing the prevalence of perinatal [anxiety disorders] is important in helping to determine the scope of the problem and supporting the recommendation for routine perinatal anxiety screening, education and referral to treatment in health care settings.”

The investigators searched the clinical online databases for relevant articles reporting the prevalence of one or more of eight common anxiety disorders in pregnant or postpartum women. Using a Bayesian multivariate modeling approach, they estimated the prevalence of each anxiety disorder in pregnant and postpartum women and potential predictor variables. Overall, 26 studies were included.

The individual prevalence estimates ranged from 1.1% for PTSD to 4.8% for specific phobia, according to the results. Fawcett and colleagues reported that the estimated prevalence of having at least one or more anxiety disorder was 20.7% (95% highest density interval [HDI], 16.7%- 25.4%) and 5.5% (about 1 in 20 women) had at least two anxiety disorders. However, due to substantial between-study heterogeneity, the “true” prevalence rate could differ broadly across samples, the researchers found.

The results also showed pregnant women were slightly more susceptible than postpartum women (21% [95% HDI, 16.7-25.8] vs. 18% [95% HDI, 13.1-24.3]). In addition, panic disorder had the highest comorbidity (60.7% chance of having another diagnosis) and the likelihood of having an additional anxiety disorder given an initial diagnosis was about 50% in most cases, the findings revealed.

“Given the personal and economic burden of both full and subthreshold [anxiety disorders], as well as potential short and long-term consequences for child development, proper screening and treatment of antenatal and postnatal [anxiety disorders] is crucial,” Fawcett and colleagues wrote. “It is time that perinatal distress no longer be synonymous only with depression.” – by Savannah Demko

Disclosure: The authors report no relevant financial disclosures.