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

围产期心理健康每年花费英国约81亿英镑（Bauer等人，2014）。围产期焦虑（PNA）是最普遍的围产期心理健康状况（Martini等人，2015; Fairbrother等人，2016年），仅PNA估计每例花费35，000英镑。尽管如此，PNA得到的经验关注相对较少（摩尔和哈里森，2018）。有必要对PNA进行进一步研究，因为据报道PNA对儿童健康有显著影响（Escherheen，Richardson和Fabio，2009年; Rees，Escheron和沃茨，2018年; Stevenson-Hinde等人，2013; Seymour等人，2014）。此外，PNA，即使在亚阈值水平，也被认为会影响母亲和儿童的健康（Ayers，科茨和Matthey，2015）ANA是一个相当新的概念。文献中的描述从自我报告的“担忧”到临床诊断的焦虑。在一项荟萃分析和系统综述中，Dennis，Falah-Hassani和Shiri（2017）发现，根据PNA的定义，患病率存在差异;临床诊断的广泛性焦虑症的产后发病率高于产前发病率;而自我报告的症状则相反。诊断率可能低估了患病率，可能是由于在披露产后焦虑时担心污名化（摩尔，艾尔斯和德雷，2016年;哈里森，摩尔和拉扎德，正在审查），或者因为目前的诊断标准可能不适合PNA（艾尔斯等人，2015; Fairbrother等人，2019;货车der Zee-货车den贝格等人，2019年）。例如，一些研究人员（Huizink等人，2004;菲利普斯等人，2009;安德森，布伦顿和干燥机，2018）认为，PNA可能不同于目前的焦虑诊断类别。无论如何，不同的流行模式和轨迹表明，需要提高方法的一致性，并考虑影响披露的因素。

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.