Anxiety Disorders During Pregnancy and the Postpartum Period: A Systematic Review.

Objective: The postpartum period is recognizedas a time of vulnerability to affective disorders, particularlypostpartum depression. In contrast, the prevalence and clinicalpresentation of anxiety disorders during pregnancy and thepostpartum period have received little research attention. Inthis article, we review the medical literature as it relates tothe prevalence and clinical presentation of panic disorder,obsessive-compulsive disorder, posttraumatic stress disorder, andgeneralized anxiety disorder during pregnancy and the postpartumperiod.

Data Sources: MEDLINE (1966 to July 2005 week 1)and PsycInfo (1840 to July 2005 week 1) were searched usingcombinations 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 publishedin English and reporting original data related to perinatalanxiety disorders were included.

Data Extraction: Studies were examined for datarelated to the prevalence, presentation, predictors/risk factors,new onset, course, and treatment of anxiety disorders duringpregnancy and the postpartum period.

Data Synthesis: Anxiety disorders are commonduring the perinatal period, with reported rates ofobsessive-compulsive disorder and generalized anxiety disorderbeing higher in postpartum women than in the general population.The perinatal context of anxiety disorders presents unique issuesfor detection and management.

Conclusions: Future research is needed toestimate the prevalence of perinatal anxiety disorders moreprecisely, to identify potential implications of maternal anxietydisorders for maternal quality of life and child development, andto determine safe and effective treatment methods.