Skip to main content
Top
Published in: Archives of Women's Mental Health 2/2017

01-04-2017 | Original Article

The prevalence and incidence of perinatal anxiety disorders among women experiencing a medically complicated pregnancy

Authors: Nichole Fairbrother, Allan H. Young, Areiyu Zhang, Patricia Janssen, Martin M. Antony

Published in: Archives of Women's Mental Health | Issue 2/2017

Login to get access

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.
Literature
go back to reference Ahmad TFE, Suleiman R, Shougah D (1994) Mixed anxiety depression in pregnancy (the influence of misconceptions). Arab Journal of Psychiatry 5(2):103–113 Ahmad TFE, Suleiman R, Shougah D (1994) Mixed anxiety depression in pregnancy (the influence of misconceptions). Arab Journal of Psychiatry 5(2):103–113
go back to reference Beauquier-Maccotta B, Chalouhi GE, Picquet A, Carrier A, Bussières L, Golse B, Ville Y (2016) Impact of monochorionicity and twin to twin transfusion syndrome on prenatal attachment, post traumatic stress disorder, anxiety and depressive symptoms. Public Library of Science One 11(1):e0145649. doi:10.1371/journal.pone.0145649 PubMedPubMedCentral Beauquier-Maccotta B, Chalouhi GE, Picquet A, Carrier A, Bussières L, Golse B, Ville Y (2016) Impact of monochorionicity and twin to twin transfusion syndrome on prenatal attachment, post traumatic stress disorder, anxiety and depressive symptoms. Public Library of Science One 11(1):e0145649. doi:10.​1371/​journal.​pone.​0145649 PubMedPubMedCentral
go back to reference Beck AT, Epstein N, Brown G, Steer RA (1988) An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 56(6):893–897CrossRefPubMed Beck AT, Epstein N, Brown G, Steer RA (1988) An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 56(6):893–897CrossRefPubMed
go back to reference Besser A, Priel B, Flett GL, Wiznitzer A (2007) Linear and nonlinear models of vulnerability to depression: personality and postpartum depression in a high-risk population. Individual Differences Research 5:1–29 Besser A, Priel B, Flett GL, Wiznitzer A (2007) Linear and nonlinear models of vulnerability to depression: personality and postpartum depression in a high-risk population. Individual Differences Research 5:1–29
go back to reference Blanchard EB, Jones-Alexander J, Buckley TC, Forneris CA (1996) Psychometric properties of the PTSD Checklist (PCL). Behav Res Ther 34(8):669–673CrossRefPubMed Blanchard EB, Jones-Alexander J, Buckley TC, Forneris CA (1996) Psychometric properties of the PTSD Checklist (PCL). Behav Res Ther 34(8):669–673CrossRefPubMed
go back to reference Chambless DL, Sharpless BA, Rodriguez D, McCarthy KS, Milrod BL, Khalsa S, Barber JP (2011) Psychometric properties of the Mobility Inventory for Agoraphobia: convergent, discriminant, and criterion-related validity. Behav Ther 42(4):689–699CrossRefPubMedPubMedCentral Chambless DL, Sharpless BA, Rodriguez D, McCarthy KS, Milrod BL, Khalsa S, Barber JP (2011) Psychometric properties of the Mobility Inventory for Agoraphobia: convergent, discriminant, and criterion-related validity. Behav Ther 42(4):689–699CrossRefPubMedPubMedCentral
go back to reference Connor KM, Davidson JRT, Churchill LE, Sherwood A, Foa E, Weisler RH (2000) Psychometric properties of the Social Phobia Inventory (SPIN): new self-rating scale. Brit J Psychiat 176:379–386CrossRefPubMed Connor KM, Davidson JRT, Churchill LE, Sherwood A, Foa E, Weisler RH (2000) Psychometric properties of the Social Phobia Inventory (SPIN): new self-rating scale. Brit J Psychiat 176:379–386CrossRefPubMed
go back to reference Coplan RJ, O’Neil K, Arbeau KA (2005) Maternal anxiety during and after pregnancy and infant temperament at three months of age. Journal of Prenatal and Perinatal Psychology and Health 19(3):199–215 Coplan RJ, O’Neil K, Arbeau KA (2005) Maternal anxiety during and after pregnancy and infant temperament at three months of age. Journal of Prenatal and Perinatal Psychology and Health 19(3):199–215
go back to reference Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression: development of the 10-item Edinburgh Postnatal Depression Scale. Brit J Psychiat 150:782–786CrossRefPubMed Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression: development of the 10-item Edinburgh Postnatal Depression Scale. Brit J Psychiat 150:782–786CrossRefPubMed
go back to reference Eberhard-Gran M, Eskild A, Tambs K, Opjordsmoen S, Samuelsen SO (2001) Review of validation studies of the Edinburgh Postnatal Depression Scale. Acta Psychiat Scand 104(4):243–249CrossRefPubMed Eberhard-Gran M, Eskild A, Tambs K, Opjordsmoen S, Samuelsen SO (2001) Review of validation studies of the Edinburgh Postnatal Depression Scale. Acta Psychiat Scand 104(4):243–249CrossRefPubMed
go back to reference Evans K, Spiby H, Morrell CJ (2015) A psychometric systematic review of self-report instruments to identify anxiety in pregnancy. J Adv Nurs 71(9):1986–2001CrossRefPubMed Evans K, Spiby H, Morrell CJ (2015) A psychometric systematic review of self-report instruments to identify anxiety in pregnancy. J Adv Nurs 71(9):1986–2001CrossRefPubMed
go back to reference Fairbrother N, Janssen P, Anthony MM, Tucker E, Young AH (2016) Perinatal anxiety disorder prevalence and incidence. J Affect Disorders 200:148–155CrossRefPubMed Fairbrother N, Janssen P, Anthony MM, Tucker E, Young AH (2016) Perinatal anxiety disorder prevalence and incidence. J Affect Disorders 200:148–155CrossRefPubMed
go back to reference Field T, Hernandez-Reif M, Vera Y, Gil K, Diego M, Bendell D, Yando R (2005) Anxiety and anger effects on depressed mother-infant spontaneous and imitative interactions. Infant Behav Dev 28(1):1–9CrossRef Field T, Hernandez-Reif M, Vera Y, Gil K, Diego M, Bendell D, Yando R (2005) Anxiety and anger effects on depressed mother-infant spontaneous and imitative interactions. Infant Behav Dev 28(1):1–9CrossRef
go back to reference First MB, Spitzer RL, Gibbon M, Williams JBW (1996) Structured clinical interview for DSM-IV Axis I Disorders. First MB, Spitzer RL, Gibbon M, Williams JBW (1996) Structured clinical interview for DSM-IV Axis I Disorders.
go back to reference Foa EB, Huppert JD, Leiberg S, Langner R, Kichic R, Hajcak G, Salkovskis PM (2002) The Obsessive-Compulsive Inventory: development and validation of a short version. Psychol Assessment 14(4):485–495CrossRef Foa EB, Huppert JD, Leiberg S, Langner R, Kichic R, Hajcak G, Salkovskis PM (2002) The Obsessive-Compulsive Inventory: development and validation of a short version. Psychol Assessment 14(4):485–495CrossRef
go back to reference Garret C (1999) Assessment for risk factors. In: Loudermilk D, Perry S, Bobak I (eds) Maternity nursing, 5th edn. Mosby, Chicago, p 578 Garret C (1999) Assessment for risk factors. In: Loudermilk D, Perry S, Bobak I (eds) Maternity nursing, 5th edn. Mosby, Chicago, p 578
go back to reference Gray BA (2006) Hospitalization history and differences in self-rated pregnancy risk. Western J Nurs Res 28:216–229CrossRef Gray BA (2006) Hospitalization history and differences in self-rated pregnancy risk. Western J Nurs Res 28:216–229CrossRef
go back to reference Henriques T, Moraes CL, Reichenheim ME, Azevedo GL, Coutinho ES, Figueira IL (2015) Postpartum posttraumatic stress disorder in a fetal high-risk maternity hospital in the city of Rio de Janeiro, Brazil. Cad Saude Publica 31(12):2523CrossRefPubMed Henriques T, Moraes CL, Reichenheim ME, Azevedo GL, Coutinho ES, Figueira IL (2015) Postpartum posttraumatic stress disorder in a fetal high-risk maternity hospital in the city of Rio de Janeiro, Brazil. Cad Saude Publica 31(12):2523CrossRefPubMed
go back to reference Huizink AC, Mulder EJH, Buitelaar JK (2004) Prenatal stress and risk for psychopathology: specific effects or induction of general susceptibility? Psychol Bull 130(1):115–142CrossRefPubMed Huizink AC, Mulder EJH, Buitelaar JK (2004) Prenatal stress and risk for psychopathology: specific effects or induction of general susceptibility? Psychol Bull 130(1):115–142CrossRefPubMed
go back to reference Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiat 62(6):593–602CrossRefPubMed Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiat 62(6):593–602CrossRefPubMed
go back to reference Kingston D, Tough S, Whitfield H (2012) Prenatal and postpartum maternal psychological distress and infant development: a systematic review. Child Psychiat Hum D 43(5):683–714CrossRef Kingston D, Tough S, Whitfield H (2012) Prenatal and postpartum maternal psychological distress and infant development: a systematic review. Child Psychiat Hum D 43(5):683–714CrossRef
go back to reference Kleinknecht RA, Thorndike RM (1990) The Mutilation Questionnaire as a predictor of blood/injury fear and fainting. Behav Res Ther 28(5):429–437CrossRefPubMed Kleinknecht RA, Thorndike RM (1990) The Mutilation Questionnaire as a predictor of blood/injury fear and fainting. Behav Res Ther 28(5):429–437CrossRefPubMed
go back to reference Klorman R, Weerts TC, Hastings JE, Melamed BG, Lang PJ (1974) Psychometric description of some specific-fear questionnaires. Behav Ther 5(3):401–409CrossRef Klorman R, Weerts TC, Hastings JE, Melamed BG, Lang PJ (1974) Psychometric description of some specific-fear questionnaires. Behav Ther 5(3):401–409CrossRef
go back to reference Kofman O (2002) The role of prenatal stress in the etiology of developmental behavioural disorders. Neurosci Biobehav R 26(4):457–470CrossRef Kofman O (2002) The role of prenatal stress in the etiology of developmental behavioural disorders. Neurosci Biobehav R 26(4):457–470CrossRef
go back to reference Manassis K, Bradley S, Goldberg S, Hood J, Swinson RP (1995) Behavioral-inhibition, attachment and anxiety in children in mothers with anxiety disorders. Can J Psychiat 40(2):87–92 Manassis K, Bradley S, Goldberg S, Hood J, Swinson RP (1995) Behavioral-inhibition, attachment and anxiety in children in mothers with anxiety disorders. Can J Psychiat 40(2):87–92
go back to reference Matthey S, Barnett B, Howie P, Kavanagh DJ (2003) Diagnosing postpartum depression in mothers and fathers: whatever happened to anxiety? J Affect Disorders 74(2):139–147CrossRefPubMed Matthey S, Barnett B, Howie P, Kavanagh DJ (2003) Diagnosing postpartum depression in mothers and fathers: whatever happened to anxiety? J Affect Disorders 74(2):139–147CrossRefPubMed
go back to reference McDonald SD, Calhoun PS (2010) The diagnostic accuracy of the PTSD checklist: a critical review. Clin Psychol Rev 30(8):976–987CrossRefPubMed McDonald SD, Calhoun PS (2010) The diagnostic accuracy of the PTSD checklist: a critical review. Clin Psychol Rev 30(8):976–987CrossRefPubMed
go back to reference Meyer TJ, Miller ML, Metzger RL, Borkovec TD (1990) Development and validation of the Penn State Worry Questionnaire. Behav Res Ther 28(6):487–495CrossRefPubMed Meyer TJ, Miller ML, Metzger RL, Borkovec TD (1990) Development and validation of the Penn State Worry Questionnaire. Behav Res Ther 28(6):487–495CrossRefPubMed
go back to reference Molina S, Borkovec TD (1994) The Penn State Worry Questionnaire: psychometric properties and associated characteristics. In: Graham D, Tallis F (eds) Worrying: perspectives on theory, assessment and treatment. John Wiley and Sons, New York Molina S, Borkovec TD (1994) The Penn State Worry Questionnaire: psychometric properties and associated characteristics. In: Graham D, Tallis F (eds) Worrying: perspectives on theory, assessment and treatment. John Wiley and Sons, New York
go back to reference Mulder EJH, Robles de Medina PG, Huizink AC, Van den Bergh BR, Buitelaar JK, Visser GH (2002) Prenatal maternal stress: effects on pregnancy and the (unborn) child. Early Hum Dev 70(1–2):3–14CrossRefPubMed Mulder EJH, Robles de Medina PG, Huizink AC, Van den Bergh BR, Buitelaar JK, Visser GH (2002) Prenatal maternal stress: effects on pregnancy and the (unborn) child. Early Hum Dev 70(1–2):3–14CrossRefPubMed
go back to reference Newman MG, Holmes M, Zuellig AR, Kachin KE, Behar E (2006) The reliability and validity of the Panic Disorder Self-Report: a new diagnostic screening measure of panic disorder. Psychol Assessment 18(1):49–61CrossRef Newman MG, Holmes M, Zuellig AR, Kachin KE, Behar E (2006) The reliability and validity of the Panic Disorder Self-Report: a new diagnostic screening measure of panic disorder. Psychol Assessment 18(1):49–61CrossRef
go back to reference O’Connor TG, Heron J, Glover V; ALSPAC Study Team (2002) Antenatal anxiety predicts child behavioral/emotional problems independently of postnatal depression. J Am Acad Child Psy 41(12):1470–1477CrossRef O’Connor TG, Heron J, Glover V; ALSPAC Study Team (2002) Antenatal anxiety predicts child behavioral/emotional problems independently of postnatal depression. J Am Acad Child Psy 41(12):1470–1477CrossRef
go back to reference O’Connor TG, Heron J, Golding J, Glover V; ALSPAC Study Team (2003) Maternal antenatal anxiety and behavioural/emotional problems in children: a test of a programming hypothesis. J Child Psychol Psyc 44(7):1025–1036CrossRef O’Connor TG, Heron J, Golding J, Glover V; ALSPAC Study Team (2003) Maternal antenatal anxiety and behavioural/emotional problems in children: a test of a programming hypothesis. J Child Psychol Psyc 44(7):1025–1036CrossRef
go back to reference Queenan JT (1985) Management of high-risk pregnancy. Medical Economics Company, New Jersey Queenan JT (1985) Management of high-risk pregnancy. Medical Economics Company, New Jersey
go back to reference Robertson E, Grace S, Wallington T, Stewart DE (2004) Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiat 26(4):289–295CrossRef Robertson E, Grace S, Wallington T, Stewart DE (2004) Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiat 26(4):289–295CrossRef
go back to reference Schneider ML, Moore CF, Kraemer GW, Roberts AD, DeJesus OT (2002) The impact of prenatal stress, fetal alcohol exposure, or both on development: perspectives from a primate model. Psychoneuroendocrinology 27(1-2):285–298CrossRefPubMed Schneider ML, Moore CF, Kraemer GW, Roberts AD, DeJesus OT (2002) The impact of prenatal stress, fetal alcohol exposure, or both on development: perspectives from a primate model. Psychoneuroendocrinology 27(1-2):285–298CrossRefPubMed
go back to reference Shlomi Polachek I, Dulitzky M, Margolis-Dorfman L, Simchen MJ (2016) A simple model for prediction postpartum PTSD in high-risk pregnancies. Arch Women Ment Hlth 19(3):483–490CrossRef Shlomi Polachek I, Dulitzky M, Margolis-Dorfman L, Simchen MJ (2016) A simple model for prediction postpartum PTSD in high-risk pregnancies. Arch Women Ment Hlth 19(3):483–490CrossRef
go back to reference Simpson W, Glazer M, Michalski N, Steiner M, Frey BN (2014) Comparative efficacy of the generalized anxiety disorder 7-item scale and the Edinburgh Postnatal Depression Scale as screening tools for generalized anxiety disorder in pregnancy and the postpartum period. Can J Psychiat 59(8):434–440 Simpson W, Glazer M, Michalski N, Steiner M, Frey BN (2014) Comparative efficacy of the generalized anxiety disorder 7-item scale and the Edinburgh Postnatal Depression Scale as screening tools for generalized anxiety disorder in pregnancy and the postpartum period. Can J Psychiat 59(8):434–440
go back to reference Sutter-Dallay AL, Giaconne-Marcesche V, Glatigny-Dallay E, Verdoux H (2004) Women with anxiety disorders during pregnancy are at increased risk of intense postnatal depressive symptoms: a prospective survey of the MATQUID cohort. Eur Psychiat 19(8):459–463CrossRef Sutter-Dallay AL, Giaconne-Marcesche V, Glatigny-Dallay E, Verdoux H (2004) Women with anxiety disorders during pregnancy are at increased risk of intense postnatal depressive symptoms: a prospective survey of the MATQUID cohort. Eur Psychiat 19(8):459–463CrossRef
go back to reference Thiagayson P, Krishnaswamy G, Lim M, Sung S, Haley C, Fung D, Allen J, Chen H (2013) Depression and anxiety in Singaporean high-risk pregnancies—prevalence and screening. Gen Hosp Psychiat 35(2):112–116CrossRef Thiagayson P, Krishnaswamy G, Lim M, Sung S, Haley C, Fung D, Allen J, Chen H (2013) Depression and anxiety in Singaporean high-risk pregnancies—prevalence and screening. Gen Hosp Psychiat 35(2):112–116CrossRef
go back to reference Wadhwa PD, Glynn L, Hobel CJ, Garite TJ, Porto M, Chicz-DeMet A, Wiglesworth AK, Sandman CA (2002) Behavioral perinatology: biobehavioral processes in human fetal development. Regul Peptides 108(2-3):149–157CrossRef Wadhwa PD, Glynn L, Hobel CJ, Garite TJ, Porto M, Chicz-DeMet A, Wiglesworth AK, Sandman CA (2002) Behavioral perinatology: biobehavioral processes in human fetal development. Regul Peptides 108(2-3):149–157CrossRef
go back to reference Walker EA, Newman E, Dobie DJ, Ciechanowski P, Katon W (2002) Validation of the PTSD checklist in an HMO sample of women. Gen Hosp Psychiat 24(6):375–380CrossRef Walker EA, Newman E, Dobie DJ, Ciechanowski P, Katon W (2002) Validation of the PTSD checklist in an HMO sample of women. Gen Hosp Psychiat 24(6):375–380CrossRef
go back to reference Weathers FW, Litz BT, Herman DS, Huska JA, Keane TM (1993). The PTSD Checklist (PCL): reliability, validity, and diagnostic utility. Paper presented at the annual convention of the International Society for Traumatic Stress Studies, San Antonio, TX Weathers FW, Litz BT, Herman DS, Huska JA, Keane TM (1993). The PTSD Checklist (PCL): reliability, validity, and diagnostic utility. Paper presented at the annual convention of the International Society for Traumatic Stress Studies, San Antonio, TX
Metadata
Title
The prevalence and incidence of perinatal anxiety disorders among women experiencing a medically complicated pregnancy
Authors
Nichole Fairbrother
Allan H. Young
Areiyu Zhang
Patricia Janssen
Martin M. Antony
Publication date
01-04-2017
Publisher
Springer Vienna
Published in
Archives of Women's Mental Health / Issue 2/2017
Print ISSN: 1434-1816
Electronic ISSN: 1435-1102
DOI
https://doi.org/10.1007/s00737-016-0704-7

Other articles of this Issue 2/2017

Archives of Women's Mental Health 2/2017 Go to the issue