Onset and exacerbation of obsessive-compulsive disorder in the perinatal period

Obsessive-compulsive disorder (OCD) can emerge during pregnancy and the postpartum and may adversely affect mother and newborn. However, little is known about potential risk factors for the onset of OCD in the perinatal period. Therefore, we investigated the onset of diagnosed DSM-5 OCD in women followed from the second trimester of pregnancy to 6-months postpartum.

We followed 256 women from the 20-24th week of pregnancy to 6-month postpartum. Participants had psychiatric diagnostic interviews at baseline and 6-month postpartum and completed self-report instruments. We compared women with and without incident OCD on sociodemographic characteristics and clinical features.

Of the 143 participants without past or current OCD at baseline, 12 (8.4%) were diagnosed with DSM-5 OCD at 6-month postpartum. The incident cases had a broad range of types of obsessions and compulsions. Compared to those who did not develop OCD, the incident cases were significantly less likely to be married, to have a college degree, or have an annual household income above $50,000, and they were more likely to be receiving public assistance and to have an unplanned pregnancy. The incident cases also had significantly higher mean scores on measures of obsessional beliefs, anxiety, and perceived stress.

A considerable proportion of pregnant women have onset of OCD during pregnancy and the postpartum, with multiple types of obsessions and compulsions. Socioeconomic circumstances, and cognitive and psychological vulnerabilities, may increase the risk of developing OCD in the peripartum.

• 256 women were followed from the 20-24th week of pregnancy to 6-month postpartum. • 12 (8%) of the women had onset of OCD during the follow-up period. • The women with OCD-onset reported fewer socioeconomic resources. • The women with OCD-onset had more psychological vulnerabilities.