Perinatal anxiety disorders, affecting as many as one in five individuals while pregnant and the postpartum period, pose a major burden on the mother and her family. These disorders, which include Generalized Anxiety Disorder, Panic Disorder, and Obsessive Compulsive Disorder, can arise prior to, during, or after pregnancy. They’ve been related to various hostile outcomes, corresponding to birth complications, longer hospital stays, and lower Apgar scores for infants. Moreover, offspring of people with perinatal anxiety have the next likelihood of experiencing mental disorders in childhood. Despite their high prevalence and impact, perinatal anxiety disorders are sometimes missed in comparison with perinatal depression.

Efforts have been made to screen for anxiety disorders in pregnant and postpartum individuals to enhance identification and intervention. 

While perinatal anxiety disorders are common, little is thought concerning the extent to which targeted interventions might be used to stop perinatal anxiety disorders. A recent systematic review and meta-analysis were conducted to look at whether psychological interventions prevent or reduce risk for perinatal anxiety disorders and which interventions are probably the most effective. The review included 36 studies that examined interventions focused on perinatal anxiety, in addition to interventions designed to stop perinatal depression. Studies varied regarding intervention approach and included CBT (10/36), mindfulness and rest (6/36), and psychoeducation (6/36).

The authors included all studies assessing perinatal anxiety symptom severity as an end result, including interventions designed to stop perinatal anxiety, to stop perinatal depression, or to deal with risk aspects related to perinatal anxiety; for instance, sleep quality and physical activity. While no significant effect was present in stopping the onset of perinatal anxiety disorders, psychological interventions were effective in reducing the severity of perinatal anxiety symptoms.

Mindfulness and cognitive behavioral therapy (CBT) approaches were particularly effective on this regard. Interventions specifically developed for perinatal anxiety were more practical than those focused on the prevention of perinatal depression. While anxiety and depression often occur together within the perinatal period, these findings suggest that counting on interventions developed to stop depression is probably not sufficient to stop anxiety. Interventions developed for other mental health conditions may lack key lively ingredients which are specific to stopping and treating anxiety disorders. 

The study highlights the potential of psychological interventions in reducing perinatal anxiety and calls for the event of interventions that specifically goal perinatal anxiety disorder prevention. The authors also emphasize the importance of including culturally relevant content and accessibility of intervention modalities with a view to effectively reach marginalized populations. Overall, more research is required to higher understand the prevention and treatment of perinatal anxiety disorders.

Ruta Nonacs, MD PhD

References

Zimmermann M, Julce C, Sarkar P, McNicholas E, Xu L, Carr C, Boudreaux ED, Lemon SC, Byatt N. Can psychological interventions prevent or reduce risk for perinatal anxiety disorders? A scientific review and meta-analysis. Gen Hosp Psychiatry. 2023 Sep-Oct;84:203-214.