The Prevalence of Anxiety Disorders During Pregnancy and the Postpartum Period : A Multivariate Bayesian Meta-Analysis

Abstract

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 one or more of eight 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 (e.g., 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 one or more disorder. Individual disorder prevalence estimates ranged from 1.1% for PTSD to 4.8% for specific phobia, with the prevalence of having at least one or more disorder estimated to be 20.7% [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 one disorder. These findings highlight the need for anxiety screening, education and referral in obstetrics and gynecology settings.