In perinatal mood and anxiety disorders

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Perinatal mood and anxiety: 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

Psychiatry in primary care toolkit

The Psychiatry in Primary Care App has been decommissioned. 

The revised print version of Psychiatry in Primary Care is avaible through the CAMH store. 

We have posted a number of revised chapters from the book in Treating Conditions and Disorders in the new Professionals section of