The course of anxiety and depression through pregnancy and the postpartum in a community sample

Background: Postnatal and antenatal depression are a focus of considerable clinical and research attention, but little is known about the patterns of anxiety across this period. Methods: Self-reported anxiety and depression were assessed at 18 and 32 weeks gestation and 8 weeks and 8 months postnatally in a prospective longitudinal study of a community sample of women in England (n=8323). Results: The majority of cases of postnatal depression were preceded by antenatal depression; similarly, postnatal anxiety was preceded by antenatal anxiety. Despite the stability of anxiety and depression across this period, there was a mean decrease in both anxiety and depression. Finally, antenatal anxiety predicted postnatal depression at 8 weeks and 8 months, even after controlling for antenatal depression (OR=3.22, p<0.001). Limitations: Data were based on self-report only and there was evidence of selective attrition. Conclusion: The findings confirm that antenatal anxiety occurs frequently, overlaps with depression and increases the likelihood of postnatal depression.