BIOLOGICAL AND PSYCHOLOGICAL PREDICTORS OF PERINATAL ANXIETY EXACERBATION

Abstract

This thesis presents research investigating the association between numerous sociodemographic, obstetrical and delivery, psychological, and biological factors with postpartum anxiety worsening in women with pre-existing anxiety disorders. First, a systematic review and meta-analysis investigating the risk factors associated with perinatal anxiety in women with and without pre-existing anxiety disorders was conducted. This investigation highlighted the lack of information pertaining to risk factors of anxiety occurring during the perinatal period, specifically in women with pre-existing anxiety disorders who are at increased risk of symptom worsening. Next, we conducted a study in which risk factors of postpartum anxiety worsening were assessed, specifically in women with pre-existing anxiety disorders. In this study, numerous sociodemographic, obstetrical and delivery, psychological, and biological factors were examined. We demonstrate that psychological factors, particularly intolerance of uncertainty, depressive symptom severity, and obsessive compulsive disorder symptoms, are significantly associated to postpartum anxiety worsening. That is, women with pre-existing anxiety disorders who exhibit heightened levels of these psychological domains during their third trimester of pregnancy are at increased risk of experiencing a relapse, or worsening, of their pre- existing anxiety symptoms during the postpartum period. This study provides a basis for future research to be conducted at investigating the associations between these risk factors and postpartum anxiety worsening. Study replication and continued research investigating the risk factors of postpartum anxiety worsening has the potential to provide valuable information in determining which women are at increased risk of worsening postpartum, with the hopes of decreasing the associated negative effects with postpartum anxiety.