Early Human Development
Volume 86, Issue 5 , Pages 305-310 , May 2010

Anxiety disorders before birth and self-perceived distress during pregnancy: Associations with maternal depression and obstetric, neonatal and early childhood outcomes

  • Julia Martini

      Affiliations

    • Institute of Clinical Psychology and Psychotherapy, Technische Universitaet, Dresden, Germany
    • Corresponding Author InformationCorresponding author. Tel.: +49 351 463 32555; fax: +49 351 463 36984.
    • These authors shared 1st authorship.
  • ,
  • Susanne Knappe

      Affiliations

    • Institute of Clinical Psychology and Psychotherapy, Technische Universitaet, Dresden, Germany
    • These authors shared 1st authorship.
  • ,
  • Katja Beesdo-Baum

      Affiliations

    • Institute of Clinical Psychology and Psychotherapy, Technische Universitaet, Dresden, Germany
  • ,
  • Roselind Lieb

      Affiliations

    • Institute of Psychology, Epidemiology and Health Psychology, University of Basel, Switzerland
    • Max Planck Institute of Psychiatry, Munich, Germany
  • ,
  • Hans-Ulrich Wittchen

      Affiliations

    • Institute of Clinical Psychology and Psychotherapy, Technische Universitaet, Dresden, Germany
    • Max Planck Institute of Psychiatry, Munich, Germany

Received 8 July 2009 ,Revised 27 January 2010 ,Accepted 20 April 2010.

References 

  1. Alder J, Fink N, Bitzer J, Hösli I, Holzgreve W. Depression and anxiety during pregnancy: a risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature. J Matern Fetal. 2007;20(3):189–209
  2. Andersson L, Sundström-Poromaa I, Wulff M, Aström M, Bixo M. Implications of antenatal depression and anxiety for obstetric outcome. Am J Obstet Gynecol. 2004;104(3):467–476
  3. Glover V, O'Connor TG. Antenatal programming of child behavior and neurodevelopment: links with maternal stress and anxiety. In:  Hodgson DM,  Coe CL editor. Perinatal programming: early life determinants of adult health and disease. London: Taylor & Francis; 2006;p. 253–265
  4. Halbreich U. The association between pregnancy processes, preterm delivery, low birth weight, and postpartum depressions—the need for interdisciplinary integration. Am J Obstet Gynecol. 2005;193(4):1312–1322
  5. Lieb R, Isensee B, Höfler M, Wittchen H-U. Parental depression and depression in offspring: evidence for familial characteristics and subtypes?. J Psychiatr Res. 2002;36:237–246
  6. Monk C. Stress and mood disorders during pregnancy: implications for child development. Psychiatr Q. 2001;72(4):347–357
  7. Schreier A, Wittchen H-U, Höfler M, Lieb R. Anxiety disorders in mothers and their children: prospective longitudinal community study. Br J Psychiatry. 2008;192:308–309
  8. Van den Bergh BRH, Mulder EJH, Mennes M, Glover V. Antenatal maternal anxiety and stress and the neurobehavioural development of the fetus and child: links and possible mechanisms. A review. Neurosci Biobehav Rev. 2005;29:237–258
  9. Austin M-P. Antenatal screening and early intervention for “perinatal” distress, depression and anxiety: where to from here?. Arch Womens Ment Health. 2004;7:1–6
  10. Austin M-P, Hadzi-Pavlovic D, Leader L, Saint K, Parker G. Maternal trait anxiety, depression and life event stress in pregnancy: relationships with infant temperament. Early Hum Dev. 2005;81(2):183–190
  11. Riecher-Rössler A, Steiner M. Perinatal stress, mood and anxiety disorders: from bench to bedside. Basel: Karger; 2005;
  12. Beesdo K, Knappe S, Pine DS. Anxiety and anxiety disorders in children and adolescents: developmental issues and implications for DSM-V. Psychiatr Clin N Am. 2009;32:483–524
  13. Wittchen H-U, Lieb R, Schuster P, Oldehinkel AJ. When is onset? Investigations into early developmental stages of anxiety and depressive disorders. In:  Rapoport JL editors. Childhood onset of “adult” psychopathology. Clinical and research advances. Washington: American Psychiatric Press; 1999;p. 259–302
  14. Wittchen H-U, Jacobi F. Size and burden of mental disorders in Europe—a critical review and appraisal of 27 studies. Eur Neuropsychopharmacol. 2005;15(4):357–376
  15. Glover V, Kammerer M. The biology and pathophysiology of peripartum psychiatric disorders. Prim Psychiatry. 2004;11(3):37–41
  16. Heron J, O'Connor TG, Evans J, Golding J, Glover V. The course of anxiety and depression through pregnancy and the postpartum in a community sample. J Affect Disord. 2004;80:65–73
  17. Vesga-Lopez O, Blanco C, Keyes K, Olfson M, Grant BF, Hasin DS. Psychiatric disorders in pregnant and postpartum women in the United States. Arch Gen Psychiatry. 2008;65(7):805–815
  18. Ross LE, McLean LM. Anxiety disorders during pregnancy and the postpartum period: a systematic review. J Clin Psychiatry. 2006;67(8):1285–1298
  19. Austin M-P, Lumley J. Antenatal screening for postnatal depression: a systematic review. Acta Psychiatr Scand. 2003;107:10–17
  20. Cooper PJ, Murray L, Hooper R, West A. The development and validation of a predictive index for postpartum depression. Psychol Med. 1996;26(3):627–634
  21. O'Hara MW, Swain AM. Rates and risk of postpartum depression—a meta-analysis. Int Rev Psychiatry. 1996;8(1):37–54
  22. Reid AJ, Biringer A, Carroll JD, Midmer D, Wilson LM, Chalmers B, et al. Using the ALPHA form in practice to assess antenatal psychosocial health. Can Med Assoc J. 1998;159(6):677–684
  23. Cooper RL, Goldenberg RL, Das A, Elder N, Swain M, Norman G, et al. The preterm prediction study: maternal stress is associated with spontaneous preterm birth at less than thirty-five weeks' gestation. Am J Obstet Gynecol. 1996;175(5):1286–1292
  24. O'Hara MW, Gorman LL. Can postpartum depression be predicted?. Prim. Psychiatry. 2004;11(3):42–47
  25. Steiner M. Postnatal depression: a few simple questions. Fam Pract. 2002;19(5):469–470
  26. Paarlberg KM, Vingerhoest JJM, Passchier J, Dekker GA, Van Geijn HP. Psychosocial factors and pregnancy outcome: a review with emphasis on methodological issues. J Psychosom Res. 1995;39(5):563–595
  27. Erickson K, Thorsen P, Chrousos G, Grigoriadis DE, Khongsaly O, McGregor J, et al. Preterm birth: associated neuroendocrine, medical, and behavioral risk factors. J Clin Endocrinol Metab. 2001;86(6):2544–2552
  28. Banhidy F, Acs N, Puho E, Czeizel AE. Association between maternal panic disorders and pregnancy complications and delivery outcomes. Eur J Obstet Gynecol Reprod Biol. 2006;124:47–52
  29. Seng JS, Oakley DJ, Sampselle CM, Killion C, Graham-Bermann S, Liberzon I. Posttraumatic stress disorder and pregnancy complications. Obstet Gynecol. 2001;97(1):17–22
  30. Warren SL, Racu C, Gregg V, Simmens SJ. Maternal panic disorder: infant prematurity and low birth weight. J Anxiety Disord. 2006;20(3):342–352
  31. Burke JD, Loeber R, Birmaher B. Oppositional defiant disorder and conduct disorder: a review of the past 10years, part II. J Am Acad Child Adolesc Psychiatry. 2002;41(11):1275–1293
  32. Rodriguez A, Bohlin G. Are maternal smoking and stress during pregnancy related to ADHD symptoms in children?. J Child Psychol Psychiatry. 2005;46(3):246–254
  33. Van den Bergh BRH, Marcoen A. High antenatal maternal anxiety is related to ADHD symptoms, externalizing problems, and anxiety in 8- and 9-year-olds. Child Dev. 2004;75(4):1085–1097
  34. O'Connor TG, Heron J, Glover V. Antenatal anxiety predicts child behavioral/emotional problems independently of postnatal depression. J Am Acad Child Adolesc Psychiatry. 2002;41(12):1470–1477
  35. O'Connor TG, Heron J, Golding J, Beveridge M, Glover V. Maternal antenatal anxiety and children's behavioural/emotional problems at 4years. Br J Psychiatry. 2002;180:502–508
  36. Hirshfeld-Becker DR, Biederman J, Faraone S, Robin JA, Friedman D, Rosenthal JM, et al. Pregnancy complications associated with childhood anxiety disorders. Depress Anxiety. 2004;19:152–162
  37. Beesdo K, Pine DS, Lieb R, Wittchen H-U. Incidence and risk patterns of anxiety and depressive disorders and categorization of general anxiety disorder. Arch Gen Psychiatry. 2010;67(1):1–12
  38. Bittner A, Egger HL, Erkanli A, Costello EJ, Foley DL, Angold A. What do childhood anxiety disorders predict?. J Child Psychol Psychiatry. 2007;48(12):1174–1183
  39. Brückl TM, Wittchen H-U, Höfler M, Pfister H, Schneider S, Lieb R. Childhood separation anxiety and the risk of subsequent psychopathology: results from a community study. Psychother Psychosom. 2007;76(1):47–56
  40. Last CG, Perrin S, Hersen M, Kazdin AE. A prospective study of childhood anxiety disorders. J Am Acad Child Adolesc Psychiatry. 1996;35(11):1502–1510
  41. Realmuto GM, Winters KC, August GJ, Lee S, Fahnhorst T, Botzet A. Drug use and psychosocial functioning of a community-derived sample of adolescents with childhood ADHD. J Child Adolesc Subst Abuse. 2009;18(2):172–192
  42. Lieb R, Isensee B, von Sydow K, Wittchen H-U. The Early Developmental Stages of Psychopathology Study (EDSP): a methodological update. Eur Addict Res. 2000;6(4):170–182
  43. Wittchen H-U, Perkonigg A, Lachner G, Nelson CB. Early Developmental Stages of Psychopathology Study (EDSP)—objectives and design. Eur Addict Res. 1998;4(1–2):18–27
  44. Lachner G, Wittchen H-U, Perkonigg A, Holly A, Schuster P, Wunderlich U, et al. Structure, content and reliability of the Munich Composite International Diagnostic Interview (M-CIDI) substance use sections. Eur Addict Res. 1998;4(1–2):28–41
  45. Reed V, Gander F, Pfister H, Steiger A, Sonntag H, Trenkwalder C, et al. To what degree does the Composite International Diagnostic Interview (CIDI) correctly identify DSM-IV disorders? Testing validity issues in a clinical sample. Int J Methods Psychiatr Res. 1998;7(3):142–155
  46. Wittchen H-U, Pfister H. DIA-X-Interviews: Instruktionsmaterial zur Durchführung von DIA-X Interviews. Frankfurt: Swets & Zeitlinger; 1997;
  47. Berkowitz GS, Papiernik E. Epidemiology of preterm birth. Epidemiol Rev. 1993;15(2):414–443
  48. Apgar V. A proposal for a new method of evaluation of the newborn infant. Curr Res Anesth Analg. 1953;32(4):260–267
  49. Stata. Stata Statistical Software. 2007.
  50. Royall M. Model robust confidence intervals using maximum likelihood estimations. Int Stat Rev. 1986;54(2):221–226
  51. Savitz DA, Olshan AF. Multiple comparisons and related issues in the interpretation of epidemiologic data. Am J Epidemiol. 1995;142(9):904–908
  52. Murray L, Cooper P, Creswell C, Schofield E, Sack C. The effects of maternal social phobia on mother–infant interactions and infant social responsiveness. J Child Psychol Psychiatry. 2007;48(1):45–52
  53. Walshe M, Rifkin L, Rooney M, Healy E, Nosarti C, Wyatt J, et al. Psychiatric disorder in young adults born very preterm: role of family history. Eur Psychiatry. 2008;23(7):527–531
  54. Hodgson DM, Coe CL. Perinatal programming: early life determinants of adult health and disease. London: Taylor & Francis; 2005;
  55. Mulder EJH, de Medina PGR, Huizink AC, Van den Bergh BRH, Buitelaar JK, Visser GHA. Prenatal maternal stress: effects on pregnancy and the (unborn) child. Early Hum Dev. 2002;70:3–14
  56. Teixeira JMA, Fisk NM, Glover V. Association between maternal anxiety in pregnancy and increased uterine artery resistance index: cohort based study. Br Med J. 1999;318:153–157
  57. Bhutta AT, Cleves MA, Casey PH, Cradock MM, Anand KJS. Cognitive and behavioral outcomes of school-aged children who were born preterm: a meta-analysis. JAMA. 2002;288(6):728–737

PII: S0378-3782(10)00087-3

doi: 10.1016/j.earlhumdev.2010.04.004

Early Human Development
Volume 86, Issue 5 , Pages 305-310 , May 2010