Postpartum anxiety: a state-of-the-art review

Abstract

Although there has been increasing interest in the study of postpartum anxiety in recent years, it remains an emerging field. We present a state-of-the-art review of postpartum anxiety, with the aim of comprehensively surveying postpartum anxiety literature and presenting a synthesis of the complete body of knowledge around postpartum anxiety. We found an estimated global prevalence of 12·3% for postpartum anxiety. Postpartum anxiety is associated with primiparity and younger maternal age. Multiple screening tools are validated for use in postpartum anxiety, although none of these tools are validated for ongoing assessment. There are very few studies of pharmacotherapy in postpartum anxiety, but cognitive behavioural therapy has promising evidence. Postpartum anxiety is associated with altered offspring biology and mental health, as well as poor maternal psychological outcomes and quality of life. We review gaps in literature, particularly in our understanding of the biology and clinical features of postpartum anxiety, as well as the limitations of current screening tools. This Review should serve as a call to action towards a rigorous and coordinated study of postpartum anxiety.