Panic disorder during pregnancy and the first three years after delivery: a systematic review
F Gerrik Verhees1, Antonia Bendau2, Stefanie Unger1,3
1Department of Psychiatry & Psychotherapy, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany.
Insights
Peripartum panic disorder (PD) has varied courses and is linked to birth complications and postpartum depression. Comprehensive monitoring of mothers and infants is crucial, with a need for more research on familial anxiety transmission.
Area of Science:
- Perinatal mental health
- Psychiatry
- Reproductive health
Background:
- Panic disorder (PD) is common during the peripartum period.
- Understanding its risk factors and outcomes is vital for maternal and infant well-being.
Purpose of the Study:
- To systematically review risk factors and course patterns of peripartum PD.
- To summarize maternal, infant, and dyadic outcomes up to three years postpartum.
Main Methods:
- Conducted a systematic literature search following PRISMA guidelines.
- Included peer-reviewed articles (1980-April 2024) on peripartum PD, risk factors, and outcomes.
- Screened 2,740 records, with 75 eligible studies from 64 projects.
Main Results:
- Maternal PD in the peripartum period shows heterogeneous, not common, trajectories.
- Maternal PD is associated with birth complications and subsequent postpartum depression.
- Evidence suggests associations between maternal PD and infant/dyadic outcomes.
Conclusions:
- Diverse outcome measures prevented a meta-analytic approach.
- Heterogeneous courses and outcomes necessitate comprehensive monitoring of mothers and infants.
- Further longitudinal studies on familial transmission of anxiety disorders are needed.
Background:
Panic disorder (PD) is highly prevalent during the peripartum period. The aim of this systematic review was to summarize evidence on risk factors and course patterns of peripartum PD as well as maternal, infant or dyadic outcomes during the first three years after delivery.
Methods:
A literature search was conducted according to PRISMA guidelines. Inclusion criteria were: (1) a diagnosis of PD or panic attacks during pregnancy, (2) risk factors and course as well as maternal, infant or dyadic outcomes measured in pregnancy and/or up to 3 years postpartum (3) peer-reviewed articles in English or German published between 1980 and April 2024. After screening of n = 2,740 records, n = 75 records based on n = 64 projects were eligible for this systematic review.
Results:
Overall, n = 47 studies investigated the course of PD during the peripartum period, n = 23 studies examined the associations of PD and obstetric, neonatal or infant outcomes, and n = 5 studies focused on the associations of PD and characteristics of the mother-infant dyad. We found (1) no common trajectory, but heterogeneous courses of maternal PD in the peripartum period, (2) associations of maternal PD with birth complications and subsequent postpartum depression, and (3) evidence for associations of PD with infant and dyadic outcomes.
Limitations:
Diverse outcome measures in recent original publications did not allow for a meta-analytic approach.
Conclusion:
Heterogenous courses and outcomes of peripartum PD require comprehensive monitoring of affected mothers and their infants. There is a need for further longitudinal investigations into familial transmission of anxiety disorders.
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