title: The prevalence and incidence of perinatal anxiety disorders among women experiencing a medically complicated pregnancy.
abstract: Over 20% of pregnancies involve medical difficulties that pose some threat to the health and well-being of the mother, her developing infant, or both. We report on the first comparison of the prevalence and incidence of maternal anxiety disorders (AD) in pregnancy and the postpartum, across levels of medical risk in pregnancy. Pregnant women (N = 310) completed postnatal screening measures for anxiety. Women who scored at or above cutoff on one or more of the screening measures were administered a diagnostic interview (n = 115) for AD. Pregnancies were classified into low, moderate, or high risk based on self-report and contact with high-risk maternity clinics. The incidence of AD in pregnancy was higher among women classified as experiencing a medically moderate or high-risk pregnancy, compared with women classified as experiencing a medically low-risk pregnancy. Across risk groups, there were no differences in AD prevalence or in the incidence of AD in the postpartum. Demographic characteristics and parity did not contribute meaningfully to outcomes. Pregnancies characterized by medical risks are associated with an increased likelihood of new onset AD. Women experiencing medically complex pregnancies should be screened for anxiety and offered appropriate treatment.
authors.affiliation: Department of Psychiatry, Island Medical Program, University of British Columbia, Queen Alexandra Centre for Children's Health, 2400 Arbutus Road, Victoria, BC, V8N 1V7, Canada. nicholef@uvic.ca.
authors.forename: Nichole
authors.initials: N
authors.lastname: Fairbrother
authors.affiliation: Institute of Psychiatry, Psychology and Neurosciences, King's College London, Strand, London, England, WC2R 2LS, UK.
authors.forename: Allan H
authors.initials: AH
authors.lastname: Young
authors.affiliation: Department of Obstetrics and Gynecology, University of Ottawa, Ottawa Fertility Centre, 955 Green Valley Crescent, Ottawa, ON, K2C 3V4, Canada.
authors.forename: Areiyu
authors.initials: A
authors.lastname: Zhang
authors.affiliation: UBC School of Population and Public Health, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada.
authors.forename: Patricia
authors.initials: P
authors.lastname: Janssen
authors.affiliation: Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, ON, M5B 2K3, Canada.
authors.forename: Martin M
authors.initials: MM
authors.lastname: Antony
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D009035:Mothers / Q000523:psychology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000523:psychology*; D018566:Pregnancy, High-Risk / Q000523:psychology*; D011295:Prenatal Care; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires
keywords: Anxiety/anxiety disorders; Epidemiology; Medically high-risk pregnancy; Pregnancy and postpartum