Study Series to Examine Post-Partum Depression's Less Famous Sibling: Perinatal AD

An upcoming series of studies will look at gaps in understanding the development, diagnosis, and treatment of perinatal mood and anxiety related disorders (AD), which account for a significant proportion of mental health conditions, according to an article in BMC Psychiatry.

Despite its high prevalence and potential negative impacts for both mother and child, perinatal AD has been much less studied than post-partum depression.

“Although a number of large-scale, high quality studies have assessed the prevalence of pre and postnatal depression (i.e., an episode of major depression), using gold standard assessment methods (i.e., diagnostic interviewing), to our knowledge, these estimates are based exclusively on episodic criteria or symptom severity; they are not based on the full diagnostic criteria for major depressive disorder,” the study authors noted. “Consequently, it is likely that bipolar conditions contribute to the prevalence of postpartum depression. This possibility, to our knowledge, remains uninvestigated, and represents one of the objectives of the current research.”

Study participants included 660 English-speaking pregnant women. Participants for the portion of the research estimating the prevalence/incidence of perinatal mood disorders and AD (N = 347) were recruited proportionally from a geographically defined area. All participants were recruited via prenatal clinic visits at hospitals, physician offices and midwifery clinics, and via community outreach at events and through word of mouth. Participants were administered questionnaires prenatally at approximately 24 and 33 weeks gestation and again at 4-6 weeks postpartum and 6-months postpartum.

In particular, the study series will examine:

· An estimate of the prevalence/incidence of the full spectrum of postpartum AD;

· The connection between anxiety during pregnancy and adverse pregnancy outcomes such as miscarriage, preeclampsia, preterm delivery, and low birth weight;

· The heightened risk of children of highly anxious mothers to develop attention deficit hyperactivity disorder;

· Prenatal anxiety as a predictor of postpartum depression;

· The extent of stress and anxiety among high-risk obstetrical patients, with an eye toward needed mental health treatments;

· Whether additional screening beyond the Edinburgh Postnatal Depression Scale is required in order to ensure adequate detection of AD among postpartum women. the temporal sequencing of AD and mood disorders during pregnancy and at 6-8 weeks postpartum; and

· The course of anxiety symptoms from pregnancy to 6—8 weeks postpartum.

Although data collection for the study is complete, manuscript preparation is currently underway.

“One area of particular importance is that of the relationship between perinatal depression and anxiety,” the study authors conclude. “Although we now know that prenatal anxiety and the presence of a prenatal AD significantly increase the risk of postpartum depression, the specific contribution of individual domains of anxiety has yet to be investigated… The findings from this series of studies has the potential to add significantly to our understanding of maternal perinatal mood and AD, stress and anxiety among women experiencing a medically high risk pregnancy, as well as treatment preferences and barriers to access among pregnant and postpartum women.”