Neuroscience Graduate Program, McMaster University, Ontario, Canada; Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Ontario, Canada.
Department of Psychology, Neuroscience, and Behaviour, McMaster University, Ontario, Canada.
J Affect Disord. 2018 Oct 1;238:626-635. doi: 10.1016/j.jad.2018.05.073. Epub 2018 Jun 18.
Even though more than 20% of women meet diagnostic criteria for an anxiety disorder during the perinatal period, very little is known about the predictors of these problems. As a result, we systematically reviewed the literature on risk factors for new onset anxiety and maternal anxiety exacerbation in the perinatal period.
PubMed, MEDLINE, PsycINFO, CINAHL, Ovid, ProQuest Portal, and Web of Science were searched for studies assessing risk factors for the development of new onset anxiety or anxiety worsening in women during pregnancy and the postpartum period.
11,759 citations were identified, with 11 studies meeting eligibility criteria. New onset anxiety was assessed in 7 studies, anxiety worsening in 3, and 1 assessed both. Lower educational attainment, living with extended family members, multiparity, a family history of psychiatric disorders, hyperemesis gravidarum, comorbid sleep disorders, and prenatal oxytocin exposure were risk factors for new onset perinatal anxiety, while presence of comorbid psychiatric disorders and prenatal oxytocin were risk factors for anxiety worsening.
Studies not explicitly stating whether participants had pre-existing anxiety disorders were excluded. As a result, meta-analysis was not possible for several risk factors.
Risk factors for new onset anxiety and anxiety worsening during the perinatal period include psychological, social, and biological exposures. Given the lack of studies differentiating women with and without pre-existing anxiety disorders, additional research is required in order to determine whether these factors differ from the non-puerperal population, as well as from each other.
尽管超过 20%的女性在围产期符合焦虑障碍的诊断标准，但对于这些问题的预测因素知之甚少。因此，我们系统地回顾了围产期新发焦虑和孕产妇焦虑恶化的危险因素的文献。
在 PubMed、MEDLINE、PsycINFO、CINAHL、Ovid、ProQuest Portal 和 Web of Science 上搜索评估新发生的焦虑或妊娠和产后期间女性焦虑恶化风险因素的研究。
确定了 11759 条引用，其中有 11 项研究符合入选标准。7 项研究评估了新发焦虑，3 项研究评估了焦虑恶化，1 项研究评估了两者。较低的教育程度、与大家庭成员同住、多胎、精神疾病家族史、妊娠剧吐、合并睡眠障碍和产前催产素暴露是围产期新发焦虑的危险因素，而合并精神疾病和产前催产素是焦虑恶化的危险因素。
排除了未明确说明参与者是否患有先前存在的焦虑障碍的研究。因此，对于几个危险因素，无法进行荟萃分析。
围产期新发焦虑和焦虑恶化的危险因素包括心理、社会和生物暴露。鉴于缺乏区分患有和不患有先前存在的焦虑障碍的女性的研究，需要进一步研究以确定这些因素是否与非产褥期人群不同，以及彼此之间是否不同。
