Identifying the women at risk of antenatal anxiety and depression: A systematic review

Abstract

BackgroundPregnancy is a time of increased vulnerability for the development of anxiety and depression. This systematic review aims to identify the main risk factors involved in the onset of antenatal anxiety and depression.MethodsA systematic literature analysis was conducted, using PubMed, PsychINFO, and the Cochrane Library. Original papers were included if they were written in English and published between 1st January 2003 and 31st August 2015, while literature reviews and meta-analyses were consulted regardless of publication date. A final number of 97 papers were selected.ResultsThe most relevant factors associated with antenatal depression or anxiety were: lack of partner or of social support; history of abuse or of domestic violence; personal history of mental illness; unplanned or unwanted pregnancy; adverse events in life and high perceived stress; present/past pregnancy complications; and pregnancy loss.LimitationsThe review does not include a meta-analysis, which may have added additional information about the differential impact of each risk factor. Moreover, it does not specifically examine factors that may influence different types of anxiety disorders, or the recurrence or persistence of depression or anxiety from pregnancy to the postpartum period.ConclusionsThe results show the complex aetiology of antenatal depression and anxiety. The administration of a screening tool to identify women at risk of anxiety and depression during pregnancy should be universal practice in order to promote the long-term wellbeing of mothers and babies, and the knowledge of specific risk factors may help creating such screening tool targeting women at higher risk.

Consequences and Possible Predictors of Health-damaging Behaviors and Mental Health Problems in Pregnancy – A Review

“…Frequently investigated socio-demographic and economic factors which can contribute to the development of depression and anxiety disorders during pregnancy include a young maternal age, being single, a low income, and a low level of education [45,46,[48][49]. Conclusive findings were most likely to be correlated to prenatal anxiety disorders [49], while the association between depressive symptoms and socio-demographic or economic factors were potentially affected by the country in which the data were collected [45][46]48]. No conclusive findings have yet been identified regarding the immigration status or ethnicity of pregnant women [46,48].…”

“…Consistent social risk factors for symptoms of depression or anxiety in pregnancy were lack of or inadequate social support by the womanʼs partner and conflicts with their partner [46,[48][49][50]. The emotional support and practical help given by the partner or by close friends or relatives plays an important role in adjusting to motherhood, managing events and coping with difficulties which can develop in the context of pregnancy and the birth of a child [45]. Frequent conflicts in their intimate relationship or dissatisfaction with their partner may be perceived as distressing by the pregnant woman and can significantly affect her adjustment to motherhood.…”

“…Appreciative and sympathetic support by the partner and emotional closeness are an important resource during the transition to parenthood which can reduce the risk of perinatal depression or anxiety [50]. Previous psychiatric illnesses of the pregnant woman -both illnesses experienced during prior pregnancies or at other stages in the womanʼs life -play an important role for the development of depression and anxiety in pregnancy [45][46]49]. But there are also indications that the majority of affected women never had a previous mental illness [45].…”

“…Previous psychiatric illnesses of the pregnant woman -both illnesses experienced during prior pregnancies or at other stages in the womanʼs life -play an important role for the development of depression and anxiety in pregnancy [45][46]49]. But there are also indications that the majority of affected women never had a previous mental illness [45]. Depression and anxiety often occur as co-morbidities, whereby pronounced symptoms of anxiety in the pregnant woman can predispose her to go on to develop depression [45].…”

“…But there are also indications that the majority of affected women never had a previous mental illness [45]. Depression and anxiety often occur as co-morbidities, whereby pronounced symptoms of anxiety in the pregnant woman can predispose her to go on to develop depression [45]. Critical life events (e.g.…”