Risk factors​

Risk factors for mood and anxiety disorders

Biological factors

• Past history of depression
• Past history of postpartum depression – up to 50 per cent recurrence for subsequent pregnancies
• Family history of mental illness – first-degree relative doubles the risk
• Recent discontinuation of antidepressants – 75 per cent relapse
• Medical or obstetrical problems
• Substance use problems

Psychosocial factors

• Unplanned pregnancy or ambivalent feelings about the pregnancy
• Marital discord
• Personality traits, for example, perfectionism
• Return-to-work pressures
• Sexual, physical, emotional abuse
• Lower socioeconomic status, financial difficulties
• Recent immigration

Consequences of untreated perinatal mood and anxiety disorders

Maternal consequences

• Progression of the mental illness
• Poor prenatal care
• Risk of medical and obstetrical complications such as gestational diabetes, premature labour
• Self-medication and substance abuse
• Impaired bonding and maternal-infant interaction
• Suicide and infanticide

Neonatal consequences

• Preterm delivery
• Poor neonatal adaptation – altered sleep, increased irritability, crying, lethargy
• Lower birth weight, associated with increased uterine artery resistance
• Greater right frontal EEG activation
• Lower dopamine and serotonin levels
• Lower scores on Brazelton Neonatal Behavioral Assessment Scale

Childhood and adolescent consequences

• Anxiety and depression, withdrawal, somatic complaints (internalizing behaviours)
• ADHD, aggression in boys, rule-breaking (externalizing behaviours)
• Increased impulsivity
• Lower scores on WISC-R intelligence subtests