Classification and outcomes of perinatal anxiety: implications for practice

Our proposed research looks to improve how we understand perinatal anxiety and its effects. The term “perinatal anxiety” refers to anxiety (excessive worrying, restlessness, nervousness) that occurs during pregnancy and/or up to 12 months after birth. During this period, women are at greater risk of experiencing common mental health disorders such as depression and anxiety. Our research will help raise awareness about this and support healthcare decisions, which is of further importance given that COVID-19 pandemic has resulted in higher number of pregnant women experiencing mental health problems. Previous research has focused on depression during the perinatal period, but we know far less about anxiety. What we do know is that anxiety may lead to depression, poor quality of life and may impact child development.

The applicants have already carried out research which examined the experiences of diagnosis and treatment of perinatal anxiety. We found that knowledge among healthcare professionals is often limited about perinatal anxiety. This is likely to have negative effects on care received by women. We propose using information from a large national database of anonymised patient records. We will use this database to identify a large group of women to compare. This group will include women who are pregnant and those who are not, women with children and those without and women with perinatal anxiety and those without. We will assess the following:
– the role of pregnancy and anxiety in terms of health and healthcare use;
– whether the children of these women experience different patterns of healthcare
use;
– whether women with perinatal anxiety can be grouped according to background factors (age, deprivation), pregnancy details (gender of the baby, delivery method and outcome), lifestyle choices, and other medical conditions;
– groups at greatest risk of increased healthcare use and those more likely to go on to experience severe mental health problems. After this, we will undertake interviews with women who have had perinatal anxiety and a range of different healthcare providers (such as, GPs, midwives). These interviews will help us to understand views on labelling women by risk, healthcare management, and training needs for staff.

Our research findings will be used to improve awareness of perinatal anxiety and to better inform decisions about treatment. Findings will be shared with members of the public and healthcare professionals. Published reports and conference presentations will be produced. We will also host an end of study workshop. In the future the team will look into how the findings from this study may lead to the development of new treatments.
A patient advisory group has supported the development of this proposal. The group will continue to provide advice during the research. Co-applicant, Amy Spruce is a member of the advisory group and will act as the group’ s spokesperson at study meetings. Our clinical and patient advisory groups will suggest ways to share findings with lay audiences, via social media such as a video animation for You-Tube or Tik-Tok.