The Risk Factors, Triggers And Trajectories Of Perinatal Anxiety: Opportunities To Support Women Through The Perinatal Period.

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Perinatal mental health costs the UK approximately £8.1billion per year (Bauer et al., 2014). Perinatal Anxiety (PNA) is the most prevalent perinatal mental health condition (Martini et al., 2015; Fairbrother et al., 2016), with PNA alone estimated to cost £35,000 per case. Despite this, PNA has received relatively little empirical attention (Moore and Harrison, 2018). Further investigation of PNA is warranted as significant effects of PNA have been reported for child wellbeing (Glasheen, Richardson and Fabio, 2009; Rees, Channon and Waters, 2018; Stevenson-Hinde et al., 2013; Seymour et al., 2014). Furthermore, PNA, even at subthreshold levels is thought to affect mother and child wellbeing (Ayers, Coates and Matthey, 2015).PNA is a fairly new concept. Descriptions in the literature vary from self-reported 'worry', to clinically diagnosed anxiety. In a meta-analysis and systematic review, Dennis, Falah-Hassani and Shiri (2017) found differences in prevalence according to how PNA was defined; postpartum rates of clinically diagnosed Generalised Anxiety Disorder were higher than antenatal rates; while the opposite pattern was true for self-reported symptoms. Diagnostic rates may underestimate prevalence, possibly due to a fear of stigma when disclosing postpartum anxiety (Moore, Ayers and Drey, 2016; Harrison, Moore and Lazard, under-review), or because current diagnostic criteria may not be appropriate for PNA (Ayers et al., 2015; Fairbrother et al., 2019; van der Zee-van den Berg et al., 2019). For example, several researchers (Huizink et al., 2004; Phillips et al., 2009; Anderson, Brunton and Dryer, 2018) have argued that PNA may be distinct from current anxiety diagnostic categories. Regardless, the varying patterns of prevalence and trajectories suggest need for greater methodological consistency and consideration of factors effecting disclosure.