Review Article: Anxiety and Depressive Disorders in Pregnancy

Background: For most expectant mothers and their partners, pregnancy is a time of joy and expectations even more so in African cultures. Sadly, even though a significant number of women face emotional challenges during pregnancy, there was little interest in studying emotional health of pregnant women as it was thought that pregnancy was protective. Several factors may have contributed to this notion. It was widely held that hormonal changes like sudden withdrawal of ‘protective pregnancy hormones’ were responsible for the high ‘incidence’ of emotional disorders in the early post-partum period. Objectives: In this article, we intend to review journal articles on anxiety and depressive disorders in pregnancy with specific references to epidemiology of anxiety and depressive disorders, pregnancy and emotional health, neurobiology of anxiety and depressive disorders in pregnancy, psychosocial origins of anxiety and depressive disorders in pregnancy, overview of perinatal mental health disorders, anxiety and depression in pregnancy, and finally risk factors for anxiety and depression in pregnancy. Method: PubMed, google, Crossref, Medline were searched using several combinations of the following search terms: pregnancy, anxiety and depressive disorders, etiology, neurobiology, and epidemiology. Study Selection: All relevant papers published in English and reporting original data related anxiety and depressive disorders in pregnancy were included. Data Extraction: Studies were examined for data related to the prevalence, presentation, predictors/risk factors, new onset, course, and treatment of anxiety disorders during pregnancy. Data Synthesis: Anxiety and depressive disorders are common during pregnancy with varying reported rates of prevalence, incidence, and severity. Conclusions: New cases of anxiety and depressive disorders do occur in pregnancy. Burden of distressing symptoms may be higher in early pregnancy. More community studies are needed to generate findings that are more representative of all pregnant women. Women should be encouraged to book for antenatal care in early pregnancy and screening measures should be instituted to detect those with clinically significant symptoms so they can be helped.