The Prevalence of Anxiety Disorders During Pregnancy and the Postpartum Period: A Multivariate Bayesian Meta-Analysis
To estimate the prevalence of anxiety disorders in pregnant and postpartum women and identify predictors accounting for variability across estimates. An electronic search of PsycINFO and PubMed was conducted from inception until July 2016, without date or language restrictions, and supplemented by a...
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| Published in: | The journal of clinical psychiatry Vol. 80; no. 4 |
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| Main Authors: | , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
United States
23-07-2019
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | To estimate the prevalence of anxiety disorders in pregnant and postpartum women and identify predictors accounting for variability across estimates.
An electronic search of PsycINFO and PubMed was conducted from inception until July 2016, without date or language restrictions, and supplemented by articles referenced in the obtained sources. A Boolean search phrase utilized a combination of keywords related to pregnancy, postpartum, prevalence, and specific anxiety disorders.
Articles reporting the prevalence of 1 or more of 8 common anxiety disorders in pregnant or postpartum women were included. A total of 2,613 records were retrieved, with 26 studies ultimately included.
Anxiety disorder prevalence and potential predictor variables (eg, parity) were extracted from each study. A Bayesian multivariate modeling approach estimated the prevalence and between-study heterogeneity of each disorder and the prevalence of having 1 or more anxiety disorder.
Individual disorder prevalence estimates ranged from 1.1% for posttraumatic stress disorder to 4.8% for specific phobia, with the prevalence of having at least 1 or more anxiety disorder estimated to be 20.7% (95% highest density interval [16.7% to 25.4%]). Substantial between-study heterogeneity was observed, suggesting that "true" prevalence varies broadly across samples. There was evidence of a small (3.1%) tendency for pregnant women to be more susceptible to anxiety disorders than postpartum women.
Peripartum anxiety disorders are more prevalent than previously thought, with 1 in 5 women in a typical sample meeting diagnostic criteria for at least 1 disorder. These findings highlight the need for anxiety screening, education, and referral in obstetrics and gynecology settings. |
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| Bibliography: | SourceType-Other Sources-1 ObjectType-Article-2 content type line 63 ObjectType-Feature-1 Author’s Note: EF, NF and JMF developed the project; EF conducted the literature search, and EF, NF and MC coded the studies; JMF and IW conceived of the statistical model; JMF implemented, conducted and presented all statistical analyses; all authors contributed to the manuscript. We would like to thank and acknowledge Dr.’s Jane Fisher, Karen Wynter, Heather Rowe, Stephen Matthey, Daisuke Nishi, and Hatta Sidi for providing their raw data; with a special thanks to Dr. Stephen Matthey for walking us through his database. We would also like to thank Bob Carpenter, Michael Betancourt and Ben Goodrich from the Stan Development Team for general feedback (provided through the Stan Users Mailing List) during the modeling process. |
| ISSN: | 1555-2101 0160-6689 1555-2101 |
| DOI: | 10.4088/JCP.18r12527 |