Background: Perinatal mental health problems are those that occur during pregnancy or up to 12 months postpartum, and affect up to 20% of women. Perinatal anxiety (PNA) is at least as common as depression during the perinatal phase and can adversely impact on both mother and child. Despite this, research into anxiety has received less attention than depression. The National Institute for Health and Care Excellence guidance on perinatal mental health has identified PNA as a research priority.
Aim: To explore the perspectives and experiences of healthcare professionals (HCPs) in the identification and management of PNA.
Design And Setting: This was a qualitative study in primary and secondary care set in the West Midlands from February 2017 to December 2017.
Method: Semi-structured interviews ( = 23) with a range of HCPs. Iterative approach to data generation and analysis, using principles of constant comparison. Patient and Public Involvement and Engagement (PPIE) group was involved throughout the study.
Results: Twenty-three HCPs interviewed: 10 GPs, seven midwives, five health visitors, and one obstetrician. Four themes were uncovered: PNA as an 'unfamiliar concept'; reliance on clinical intuition and not clinical tools; fragmentation of care; and opportunities to improve care.
Conclusion: Awareness and understanding of PNA among HCPs is variable, with debate over what is 'normal' anxiety in pregnancy. HCPs suggested that PNA can be challenging to identify, with mixed views on the use and value of case-finding tools. Opportunistic identification was noted to be significant to aid diagnosis. Care for women diagnosed with PNA was reported to be fragmented and interprofessional communication poor. Potential solutions to improve care were identified.
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http://dx.doi.org/10.3399/bjgp19X706025 | DOI Listing |
J Addict Med
November 2024
From the, Kaiser Permanente Washington Health Research Institute, Seattle, WA (GTL); Department of Health Systems and Population Health, University of Washington, Seattle, WA (GTL); Division of Research, Kaiser Permanente Northern California, Oakland, CA (FWC, KCY-W, MBD, CIC); Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA (KCY-W, CIC); and Regional Offices, Kaiser Permanente Northern California, Oakland CA (DA, CC, AHA, AE).
Objectives: Assessment and counseling are recommended for individuals with prenatal cannabis use. We examined characteristics that predict prenatal substance use assessment and counseling among individuals who screened positive for prenatal cannabis use in prenatal settings.
Methods: Electronic health record data from Kaiser Permanente Northern California's Early Start perinatal substance use screening, assessment, and counseling program was used to identify individuals with ≥1 pregnancies positive for prenatal cannabis use.
BMC Pregnancy Childbirth
January 2025
REALIFE Research Group, Women and Child, Department of Development and Regeneration, KU Leuven, Louvain, 3000, Belgium.
Aim: To understand the extent and type of evidence in relation to the effectiveness of intervention strategies targeting working pregnant women, and their partners, for the prevention of mental health problems (depression, anxiety) and improving resilience, from conception until the child is 5 years of age.
Methods: A scoping review was conducted searching Pubmed (including Medline), Embase, Web of Science Core Collection and Scopus. Inclusion criteria were based on population (employed parents), context (from -9 months to 5 years postpartum) and concept (mental health problems, resilience and prevention/ preventative interventions).
BMJ Ment Health
January 2025
Department of Primary Care and Population Health, University College London, London, UK.
Background: There is some evidence that perinatal anxiety (PNA) is associated with lower rates of infant vaccinations and decreased access to preventative infant healthcare, but results across studies have not been conclusive.
Objective: To investigate the relationship between maternal PNA and infant primary care use.
Methods: Cohort study of mother-infant pairs identified between 1998 and 2016 using IQVIA Medical Research Database (IMRD).
J Affect Disord
January 2025
School of Psychology and Counselling, The Open University, Milton Keynes, UK.
Background: Reducing the prevalence and consequences of anxiety following childbirth (postpartum anxiety) is a strategic priority in the UK and many similar nations; a comprehensive review of risk factors can support the development of interventions and guide further research.
Methods: This registered systematic review was guided by 'Preferred Reporting Items for Systematic Reviews and Meta-Analyses' (PRISMA) and analysed using 'Synthesis Without Meta-analysis' (SWiM) to answer the question; 'What factors have been reported to increase the risk of maternal postpartum anxiety (PPA) in Australia, Europe, and North America?'. MEDLINE and PsycINFO were searched for relevant research from Australia, Europe, and North America, published up to July 2021.
BMC Pregnancy Childbirth
January 2025
Department of Nutritional Sciences, School of Human Ecology, College of Natural Sciences, Department of Women's Health & Pediatrics, Dell Medical School, Dell Pediatric Research Institute, Population Research Center, The University of Texas at Austin, 1400 Barbara Jordan Blvd., Austin, TX, 78723, USA.
Background: While the striking impact of the COVID-19 pandemic on mental health, heath care access and lifestyle behaviors, including perceived health, diet, physical activity, and sleep has been reported, few studies have examined these domains jointly among pregnant and postpartum people in the early stages of the COVID-19 pandemic.
Methods: This mixed methods study was conducted among a subset of participants (n = 22) in a cohort study in Austin, Texas, who were pregnant or had recently delivered when the outbreak occurred. Measures were from the early second trimester up to 6 months postpartum.
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