data supplement to dennis et al. prevalence of antenatal ...... · 12 weeks=5.9%; 52 weeks=6.0% 24...
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Data supplement to Dennis et al. Prevalence of antenatal and postnatal anxiety: systematic review and meta-analysis. Br J Psychiatry doi: 10.1192/bjp.bp.116.187179
Table DS1: PubMed search strategy made on January 13, 2016
Search Query No of items found
#1
Postpartum period[MeSH Terms] OR postpartum[Text Word] OR puerperium[Text Word] OR pregnancy[MeSH Terms] OR pregnancy[Text Word] ORgestation[Text Word] OR postbirth[Text Word] OR post-birth[Text Word] OR antenatal[Text Word] OR prenatal[Text Word] OR postnatal[Text Word]
964,783
#2
Mood disorders[MeSH Terms] OR mood disorders[Text Word] OR depressive disorder[MeSH Terms] OR depression, postpartum[MeSH Terms] OR depression[MeSH Terms] OR depressive symptoms[Text Word] OR depression[Text Word] OR anxiety disorders[MeSH Terms] OR anxiety[MeSH Terms] OR anxiety[Text Word]
477,403
Final #1 AND #2 21,487
2
Table DS2: Characteristics of Included Studies
Author Year Country Study population Sample
size
Anxiety Assessment Quality Rating for Risk of Bias Results
Measure Cut-off Time Selection Detection Attrition
Aaron 2015 1 USA Pregnant women from an obstetrics clinic
affiliated with a hospital in Philadelphia 113 STAI >39 2nd to 3rd trimester
1 to 24 weeks High Moderate Moderate
Anxiety symptoms 2nd -3rd trimester=27.4% 1-24 weeks=21.2%
Cheng 2015 2 Singapore Pregnant women receiving an ultrasound at
two public maternity units (cohort design) 1058 STAI-S STAI-T
>41 >43 2nd trimester High Moderate Low Anxiety symptoms=26.3%
Trait=25.5% Fontein-Kuipers 2015 3
Netherlands Pregnant women from 140 midwife-led primary care practices 458
PRAQ
STAI
>90th percentile
>41 All
trimesters High Moderate Low Anxiety symptoms=11.8% Trait=14.4%
Ibanez 2015 4 France
Pregnant women receiving care from two university maternity units in Nancy and Poitiers (cohort design)
1719 STAI ≥37 2nd trimester High Moderate Low Anxiety symptoms=21.1%
Mahenge 2015 5 Tanzania Pregnant women attending a hospital-based
prenatal clinic in Dar es Salaam 1180 HSCL > 1.75 All trimesters Moderate Moderate Low Anxiety symptoms=8.1%
Pazzagli 2015 6 Italy Pregnant women from a hospital in Perugia 158 STAI >40 3rd trimester Moderate Moderate Low Anxiety symptoms=30%
Trait=25%
Bjørk 2015 7 Norway
Pregnant women without epilepsy and chronic medical conditions (population-based study; control group) (cohort design)
93,422 HSCL >1.75 3rd trimester
24 weeks 18 months
High Moderate Low Anxiety symptoms 3rd trimester=5.8% 24 weeks=4.8%;18 months=5.2%
Dubber 2015 8 Germany Pregnant women from a hospital in
Heidelberg (cohort design) 79 STAI > 40 3rd trimester 12 weeks Moderate Moderate Low
Anxiety symptoms 3rd trimester=29.6%; 12weeks=10.1% Trait 3rdtrimester=23.6%;12 weeks=14.3%
Enatescu 2014 9 Romania Postpartum women from a single clinic in
Timisoara 80 BAI >16 6–8 weeks Moderate Moderate Low Anxiety symptoms=46.3%
Pisoni 2016 10 Italy
Pregnant women with no complications attending a 3rd trimester ultrasound scan in Pavia
37 STAI > 40 3rd trimester Moderate Moderate Low Anxiety symptoms=27.0%
Razurel 2015 11 Switzerland Pregnant women attending their last prenatal
visit at a maternity hospital in Geneva 235 STAI >40 3rd trimester
3 days 6 weeks
Moderate Moderate Low Trait 3rd trimester=35.7% 3 days=30.7%; 6 weeks=27.8%
Rosenthal 2015 12 USA Pregnant women at 7 community hospitals
and health centers across New York City 1230 GAD-7 >10 2nd trimester Moderate Moderate Low Anxiety symptoms= 20%
Vilela 2015 13 Brazil Pregnant women at a public health care
centre in Rio de Janeiro 196 STAI ≥ 40 2nd and 3rd trimester
4-6 weeks High Moderate Low
Anxiety symptoms 2nd trimester=43.9%; 3rd trimester=48.2% 4-6 weeks=31.7%
3
Betts 2014 14
Australia
Pregnant women attending their first prenatal care visit at a Brisbane hospital 4891 DSSI Top 10%
1st trimester 3-5 days 24 weeks
Moderate Moderate Moderate Anxiety symptoms 1st trimester=8.9% 3-5 days=11.6%; 24 weeks=10.2%
Broekman 2014 15 Singapore Pregnant women from the two major
hospital maternity units 1034 STAI ≥ 40 2ndtrimester 12 weeks 52 weeks 24 months
Moderate Moderate High
Anxiety symptoms 2nd trimester=30.3%; 12 weeks=28.5% 52 weeks=31.8%; 24 months=30.1% Trait 2nd trimester=35.8%; 12 weeks=35.4% 52 weeks=38.0%; 24 months=38.2%
Ferreira 2014 16 Brazil Pregnant women who had their prenatal care
in Alfenas-MG 203 STAI
> sample mean 3rd trimester High Moderate Low Anxiety symptoms=58.5%
Trait=53.2% Garthus-Niegel 2014 17
Norway Pregnant women who attended a hospital near Oslo for a routine ultrasound (cohort design)
1700 HSCL >1.75 3rd trimester 8 weeks Low Moderate High Anxiety symptoms
3rd trimester=8.4%;8 weeks=4.8%
Guo 2014 18
Ghana Côte d’Ivoire
Postpartum women from two large hospitals in Kumasi and Abidjan (cohort design) 614 GAD-7 > 10
12 weeks 52 weeks 24 months
Moderate Moderate High Anxiety symptoms 12 weeks=5.9%; 52 weeks=6.0% 24 months=3.9%
Huizink 2014 19 Netherlands
Pregnant women attending midwifery practices in the vicinity of Amsterdam (cohort design)
1059 STAI > 40 1st, 2nd and 3rdtrimester Moderate Moderate Low
Anxiety symptoms 1st trimester=16.5%;2nd trimester=13.3% 3rd trimester=15.4%
Khashan 2014 20
UK, NZ, Australia,
Ireland
Pregnant women receiving antenatal care in six centres: Manchester, London, Leeds, Auckland, Adelaide, Cork (cohort design)
4896 STAI >75th percentile 2nd trimester Moderate Moderate Low Anxiety symptoms=20.1%
McDonald 2014 21 Canada
Pregnant women receiving antenatal care across Alberta (population-based; cohort design)
2907 STAI > 40 1st to 2nd trimesters Low Moderate Low
Anxiety symptoms 1st-2nd trimester=15.5%; 16 weeks=14.9%
Meijer 2014 22 Netherlands
Pregnant women from 116 primary and secondary obstetric care centres (cohort design)
1603 STAI 6-item ≥42
1st and 3rd trimesters
Moderate Moderate High
Anxiety symptoms 1st trimester=12% 3rd trimester=14%
Jokic-Begic 2014 23 Croatia Pregnant women attending a prenatal clinic
at a university hospital in Zagreb 200 STAI >40 3rd trimester 4-6 weeks Moderate Moderate Moderate Anxiety symptoms
3rd trimester=35%; 4-6 weeks=20% Polachek 2014 24 Israel Postpartum women from a maternity ward in
Ramat Gan (cohort design) 89 modified STAI > 5 4 weeks Moderate Moderate Low Anxiety symptoms=40.4%
Rubertsson 2014 25 Sweden Pregnant women attending their first
antenatal visit in 25 clinics in mid-Sweden 916 HADS-A > 8 1st trimester Moderate Moderate Low Anxiety symptoms=15.6%
Sanchez 2014 26 Peru Women who delivered in two hospitals in
Lima 480 DASS-21 >10 Immediate
post-birth Moderate Moderate Low Anxiety symptoms=8.1%
Tan 2014 27 Malaysia Pregnant women attending routine antenatal care at a university hospital in Kuala Lumpur
113 DASS > 8 3rd trimester High Moderate Low Anxiety symptoms=61.1%
Verreault 2014 28 Canada Pregnant women attending a hospital
antenatal clinic or an ultrasound in Montreal 364 STAI >40 3rd trimester
12 weeks 24 weeks
Moderate Moderate Moderate Anxiety symptoms 3rd trimester=26.6% 12 weeks=18%; 24 weeks=19.7%
Bindt 2013 29
Ghana Côte d’Ivoire
Pregnant women from two large hospitals in Kumasi and Abidjan 716 GAD-7 > 10 3rd trimester Moderate Moderate Low Anxiety symptoms=14.2%
Bödecs Hungary Pregnant women receiving prenatal care in the district nurse office in Szombathely 498 STAI > 48 1st trimester
(M=8.2weeks) High Moderate Low Trait=14.2%
4
2013 30 (cohort design)
Dennis 2013 31 Canada
Postpartum women from a health region near Vancouver, British Columbia (cohort design)
565 STAI > 40 1,4 and 8 weeks Moderate Moderate Low
Anxiety symptoms 1 week=22.6%; 4 weeks=17.2% 8 weeks=14.8%
Fadzil 2013 32 Malaysia Pregnant women at an antenatal clinic from
a tertiary hospital in Ipoh 175 HADS MINI
> 8 DSM-IV
1st, 2nd, and 3rd trimesters Moderate
Moderate for HADS
low for MINI
Low Anxiety symptoms=23.4% Any anxiety disorder=9.1%
Farias 2013 33 Brazil Pregnant women at a public health centre in
Rio de Janeiro 239 MINI DSM-IV 1sttrimester Moderate Low Low Generalized anxiety=10.5%
George 2013 34 France
Pregnant women who attended hospital birth preparation classes or a midwifery consultation in Lorraine
400 HADS > 10 3rd trimester 6-8 weeks High Moderate High Anxiety symptoms
3rd trimester=18.5%; 6-8 weeks=20.2%
Makara –Studzińska 2013 35
Poland Pregnant women attending state or private obstetric clinics in the Lublin and Mazoviaprovinces (cohort design)
314 HADS > 11 1st, 2nd, and 3rdtrimesters Moderate Moderate Low
Anxiety symptoms 1st trimester=13.4%;2nd trimester=7.3% 3rd trimester=4.6%
Martini 2013 36 Germany Pregnant women from outpatient clinics in
the area of Dresden (cohort design) 306 CIDI DSM-IV
1st, 2nd and 3rd trimesters
8 and 16 weeks
16 months
Moderate Low Low
Any anxiety disorder 1st trimester=21.2%; 2nd trimester=13.3% 3rd trimester=9.4%; 8weeks=7.5%; 16 weeks=6.4%; 16 months=12.7% Generalized anxiety 1st trimester=1.3%; 2nd trimester=0.3% 3rd trimester=1.8%; 8 weeks=0.4% 16 weeks=1.8%; 16 months=1.9%
Paul 2013 37 USA Postpartum women who delivered in
Hershey, Pennsylvania (cohort design) 1123
STAI >40 3-5 days;
2, 8, and 24 weeks
Moderate Moderate Low Anxiety symptoms 3-5 days=17.1%; 2 weeks=6.9% 8 weeks=5.8%; 24 weeks=7.2%
Roos 2013 38
South Africa
Pregnant women attending midwifery/ obstetric units in the East Metro region of the Western Cape (random sample)
105 STAISCID
>40 DSM-IV
2nd and 3rd trimesters Moderate Moderate Low
Anxiety symptoms 2nd trimester=4.3%;3rd trimester=48.6% Trait: All trimester=56% Any anxiety disorder: All trimesters=6% Generalized anxiety: All trimesters=1%
Taylor 2013 39 Australia
Postpartum women at two public tertiary hospitals, one private hospital, and one birth centre (cohort design)
504 STAI >40 1, 6, 12 and 24 weeks High Moderate Low
Anxiety symptoms 1 week=9.6%; 6 weeks=9.6% 12 weeks=9.5%; 24 weeks=9.6%
Bouris 2012 40 Canada
Postpartum women at six hospitals in Montreal, one hospital in Vancouver and five hospitals in Toronto (cohort design)
507 HSCL >1.75 16 weeks High Moderate Low Anxiety symptoms=10.7%
Da Silva 2012 41 Brazil
Pregnant women attending an ultrasound examination in the Hospital do Servidor Publico Estadual
146 STAI > 40 1st to 2nd trimester High Moderate Low Anxiety symptoms=47.3%
O’Hara 2012 42 USA Postpartum women in four rural and urban
counties in Iowa (cohort design) 1077 BAI (6 items)
> 6 DSM-IV
Across 1st year High Moderate Low Anxiety symptoms=15.6%
Generalized anxiety=15.7%
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SCID (M=21 weeks) Tavares 2012 43
Brazil Postpartum women in Pelotas (cohort design) 919 MINI DSM-IV 4-12 weeks Low Low Low
Any anxiety disorder=18.5% Generalized anxiety=12.3%
Alder 2011 44 Switzerland Pregnant women from a university hospital
obstetric department in Basel 39 STAI > 40 3rd trimester High Moderate Low Trait=28.2%
Buist 2011 45 USA
Pregnant women from obstetric services throughout Connecticut and Western Massachusetts
2793 CIDI DSM–IV 1st, 2nd and 3rd trimester Low Low Low
Generalized anxiety 1st trimester=5.4% 2nd to 3rd trimesters=4.2% All trimesters=9.6%
Edhborg 2011 46 Bangladesh
Women in two rural areas of Mymensingh district(cohort design)
674 STAI >46 8-12 weeks Moderate Moderate Low Anxiety symptoms=38.3%
Figueiredo 2011 47 Portugal
Pregnant women at a public obstetrics out-patient unit in Porto (random sample) (cohort design)
260 STAI > 45
1st, 2nd and 3rd trimesters
Post-birth 12 weeks
Moderate Moderate Low
Anxiety symptoms 1st trimester=13.1%; 2nd trimester=12.3% 3rd trimester=18.1% Post-birth=18.6%; 12 weeks=4.7%
Ibanez 2012 48 France Pregnant women from two university
maternity units in Nancy and Poitiers 1719 STAI ≥37 2nd trimester High Moderate Low Anxiety symptoms=7.9%
Keim 2011 49 USA
Pregnant women in North Carolina who participated in the PIN (Pregnancy, Infection, and Nutrition) study (cohort design)
358 STAI >40 1st to 2nd trimester Moderate Moderate High Trait=24.9%
Mohammad 2011 50 Jordan Pregnant women from a teaching hospital
and five health centres in Irbid 353 DASS-21 >10
3rd trimester 6 and 24 weeks
Moderate Moderate Low Anxiety symptoms 3rd trimester=14.4% 6 weeks=22.7%; 24 weeks=24.4%
Nasreen 2011 51 Bangladesh
Pregnant women in a pregnancy registration from two rural areas in the Mymensingh district
720 STAI ≥45 3rd trimester Moderate Moderate Low Trait=29.4%
Ajslev 2010 52 Denmark
Postpartum women participating in the Danish National Birth Cohort (DNBC)(cohort design)
21121 SCL-90
(3 items)
> 4 24 weeks Moderate Moderate Moderate Anxiety symptoms=2.6%
Amr 2010 53
Saudi Arabia
Postpartum women attending primary health care centres in Al-Ahsa 190 MINI DSM–IV Within 8
weeks Moderate Low Low Any anxiety disorder=15.3% Generalized anxiety=2.6%
Austin 2010 54 Australia Postpartum women who delivered at
midwife-based clinics in Sydney 1549 CIDI DSM-IV 24-32 weeks Moderate Low Moderate Generalized anxiety=3.1%
Catov, 2010 55 USA Pregnant women from a hospital in
Pittsburgh, Pennsylvania 667 STAI > 75th percentile
2nd trimester (M=18weeks) Moderate Moderate Low Trait=24.4%
Fisher 2010 56 Vietnam Pregnant women in two northern
Vietnamese provinces (random sample) 199 SCID DSM–IV 3rd trimester 4-8 weeks Low Low Low Generalized anxiety
3rd trimester=6.5%; 4-8 weeks=8.5%
Fisher 2010 57 Australia
Postpartum women from 3 rural areas in Victoria and from 4 metropolitan areas in Melbourne (control group)(cohort design)
196 CIDI DSM-IV 1-24 weeks Moderate Low Low Any anxiety disorder=10.2%
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Feldman 2009 58 Israel Postpartum women from two hospitals in a
large metropolitan area (cohort design) 971 STAI > 43 Post-birth Moderate Moderate Low Trait=12.2%
Giakoumaki 2009 59 Greece Postpartum women from a public perinatal
centre in Athens (cohort design) 235 STAI > 40 2–3 days 12 weeks Moderate Moderate Moderate
Anxiety symptoms 2-3 days=22.9%; 12 weeks=2.6% Trait 2-3 days=24.6%; 12 weeks=14.3%
Goodman 2010 60 USA Pregnant women attending two obstetrical
clinics in Boston 491 PHQ DSM-IV 3rd trimester 6 weeks High Moderate Moderate Any anxiety disorder
3rd trimester=4.3%; 6 weeks=3.4% Reck 2009 61 Germany Postpartum women at six clinics in
Heidelberg and Darmstadt (cohort design) 853 SCID DSM-IV 1-12 weeks Moderate Low Low Any anxiety disorder=2.7%
Uguz 2010 62 Turkey Pregnant women attending a university
affiliated obstetric clinic in Selcuk 309 SCID DSM-IV 1st, 2nd and 3rd trimester Moderate Low Low
Any anxiety disorder 1st trimester=15.5%;2nd trimester=7.6% 3rdtrimester=24.2%; All trimesters=15.5% Generalized anxiety All trimesters=3.6%
Yelland 2010 63 Australia Postpartum women who delivered in
Victoria and South Australia 4269 DASS-21 >10 24 weeks High Moderate Low Anxiety symptoms=8.4%
Couto 2009 64 Brazil
Pregnant women receiving routine prenatal care at two municipal healthcare clinics in Campinas (control group)
120 HADS ≥ 8 2nd trimester Moderate Moderate Low Anxiety symptoms=33.3%
Faisal-Cury 2009 65 Brazil
Pregnant women in 10 public primary health care units in Butanta, Rio Pequeno and Raposo Tavares in São Paulo
831 CIS-R > 12 2nd to 3rd trimester Low Moderate Low Any anxiety disorder=33.3%
Hall 2009 66 Canada
Pregnant women from communities across British Columbia with 150 births or more annually
650 STAI >40 3rd trimester Moderate Moderate Low Anxiety symptoms=29.4%
van Batenburg-Eddes 2009 67
Netherlands Pregnant women in Rotterdam whose delivery data was between April 2002 and January 2006 (population-based study; cohort design)
2451 BSI >
85thpercentile
2nd trimester 8 weeks Moderate Moderate High
Anxiety symptoms 2nd trimester=8.7%; 8 weeks=6.6%
Zanardo 2009 68 Italy Postpartum women before hospital discharge
in the north-eastern Veneto region 204 STAI >45 3-4 days Moderate Moderate Low Trait=39.15%
Anderson 2008 69 Canada Postpartum women from seven ultrasound
clinics in London, Ontario (cohort design) 651 STAI ≥ 90th percentile 8-52 weeks Moderate Moderate Moderate Anxiety symptoms=8.8%
Britton 2008 70 USA
Postpartum women from a university medical center in Salk Lake City (cohort design)
359 STAI > 40 Post-birth 4 weeks High Moderate Moderate Anxiety symptoms
Post-birth=24.3%; 4 weeks=30.7%
DiPietro 2008 71 USA Pregnant women with an uncomplicated
pregnancy in Baltimore 137 STAI > 40 3rd trimester
6 weeks 24 months
High Moderate Moderate
Anxiety symptoms:3rd trimester=28.5% 6 weeks=24.2%; 24 months=19.4% Trait: 3rd trimester=28.5% 6 weeks=24.2%; 21.4%
Grant 2008 Australia Pregnant women recruited during routine 100 STAI > 40 All High Moderate Moderate Anxiety symptoms: 1-28 weeks=33%
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72 antenatal care at an obstetric hospital in Sydney (cohort design)
MINI DSM-IV trimesters (M=16weeks)
1-28 weeks
Trait: 1-28 weeks=26% Any anxiety disorder All trimester=21%; 1-28 weeks=20%
Keeton 2008 73 USA Pregnant women attending hospital prenatal
classes in western New England 153 STAI > 40 3rd trimester 4, 16, 24 and
52 weeks Moderate Moderate Low
Anxiety symptoms 3rd trimester=36% 4 weeks=19.6; 16 weeks=30.2% 24 weeks=36.1%; 52 weeks=27.4%
Mann 2008 74 USA
Pregnant women at two obstetrics practices in a south-eastern state capital and one practice in a gulf south state capital
344 HADS > 10 All
trimesters (M=10weeks)
Moderate Moderate Low Anxiety symptoms=6.7%
Rowe 2008 75 Australia Postpartum women attending a mother-baby
unit or health service centre in Melbourne 138 CIDI DSM-IV M=29 ± 10.3 weeks Moderate Low Low Any anxiety disorder=25.4%.
Generalized anxiety=10.9% Sato 2008 76 Japan Postpartum women from 25 collaborating
birth centres (cohort design) 1348 HADS >10 12-16 weeks 40-44 weeks High Moderate High Anxiety symptoms
12-16 weeks=9.6%;40-44 weeks=10.6%
Vesga-Lopez 2008 77
USA Subsample of pregnant women who were part of a national survey (cohort design)
994
AUDADIS-IV DSM-IV
All trimesters
1-52 weeks Low Low Low
Any anxiety disorder All trimesters=13.0%;1-52 weeks=12.3% Generalized anxiety All trimester=1.3%; 1-52 weeks=1.5%
Faisal-Cury 2007 78 Brazil Pregnant women in a private obstetric clinic
in Osasco, São Paulo 432 STAI > 40 2nd to 3rd trimester Moderate Moderate Low Anxiety symptoms=59.5%
Trait=45.3% Goebert 2007 79 USA Pregnant women at prenatal clinics and
private physicians offices on Oahu, Hawaii 84 STAI > 40 1st trimester Moderate Moderate Low Anxiety symptoms=27%
Gonidakis 2007 80 Greece Postpartum women at a university
department of obstetrics in Athens 405 STAI >40 1st day post-birth Moderate Moderate Low Anxiety symptoms=16.0%
Trait=7.4%
Lee 2007 81 Hong Kong
Pregnant women attending an antenatal clinic of a regional hospital (cohort design) 335 HADS > 7 1st, 2nd and
3rd trimesters Moderate Moderate Low Anxiety symptoms 1sttrimester=36.3%;2ndtrimester=32.3% 3rdtrimester=35.8%
Orr 2007 82 USA Pregnant women who attended four hospital-based prenatal clinics in Baltimore (cohort design)
1820 PSEI 6 items > 4 1st and 2nd
trimester Moderate Moderate Low Anxiety symptoms=28%
Shi 2007 83 China Pregnant women from two obstetrical hospitals in Shanghai (cohort design) 522 HADS > 9
2nd and 3rd trimesters
1, 6, and 12 weeks
Moderate Moderate Moderate
Anxiety symptoms 2nd trimester=5.0%;3rd trimester =6.6% 1 week=4.4%; 6 weeks=4.1% 12 week=2.2%
Clifford 2006 84 Canada
Postpartum women from two hospitals in London, Ontario (cohort design)
733 STAI ≥75th
percentile 1 and 24 weeks Moderate Moderate Moderate
Anxiety symptoms 1 week=27.2%; 24 weeks=24.6% Trait 1 week=26.7%; 24 weeks=23.8%
Adewuya 2005 85 Nigeria Postpartum women who delivered in 5
government health centres in Ilesa 631 SAS >40 1, 4, 8, 12, 24, and 36
weeks Moderate Moderate Moderate
Anxiety symptoms 1 week=28.1%; 4 weeks=17.9% 8 weeks=10.2%;12 weeks=10.1% 24 weeks=8.2%; 36 weeks=6.3%
Austin 2005 86 Australia Women at midwife-based hospital clinics in
Sydney (random sample; cohort design) 964 STAI > 40 3rd trimester (M=32 Moderate Moderate Moderate Trait=25.3%
8
weeks)
Berle 2005 87 Norway Population-based general health survey
(cohort design) 680 HADS > 8 1st, 2nd and 3rd trimester Moderate Moderate Low
Anxiety symptoms 1st trimester=11.6%;2nd trimester=7.5% 3rd trimester=12.3%; All trimesters=10.4%
Coates 2004 88 USA
Postpartum women who were members of the Kaiser Permanente Medical Care Program in the northern California
25,296 ICD-9 Physician diagnosis 1-52 weeks Moderate Low Low
Any anxiety disorder 1-8 weeks=0.7%; 9-16 weeks=0.5% 17-32 weeks=1.2%; 33-52 weeks=1.3% Across postpartum=3.7%
Heron 2004 89
UK Pregnant women living in the geographical area of Avon, England (cohort design) 8323 CCEI ≥ 9 (top
15%)
2nd and 3rd trimesters 8 and 23 weeks
Low Moderate Moderate Anxiety symptoms 2nd trimester=14.6%;3rd trimester=15.6% 8 weeks=8.1%; 32 weeks=9.1%
Sutter-Dallay 2004 90 France
Pregnant women attending antenatal clinics at a university affiliated hospital in Bordeaux (cohort design)
497 MINI DSM-IV 3rd trimester 6, 12, and 24
weeks High Low Low
Any anxiety disorder:3rd trimester=24% Generalized anxiety:3rd trimester=8.5% 6 weeks=5.4%; 12 weeks=4.3% 24 weeks=4.2%
Andersson 2003 91 Sweden Pregnant women attending a routine
ultrasound at two northern hospitals 1556 PRIME-MD DSM-IV 2nd trimester Moderate Low Low Any anxiety disorder=6.6%
Generalized anxiety=0.3%
Dole 2003 92 USA
Pregnant women attending prenatal clinics in central North Carolina who participated in the PIN (Pregnancy, Infection, and Nutrition) study (cohort design)
1703
Pregnancy-
related anxiety, 6 items
low medium
high 2nd trimester High Moderate Low Anxiety symptoms=17.9%
Eberhard-Gran 2003 93
Norway Postpartum women from two municipalities northeast of Oslo (population-based; cohort design)
416 SCL-25 > 18 6 weeks Moderate Moderate Low Anxiety symptoms=4.9%
Matthey 2003 94 Australia Pregnant women attending hospital-based
antenatal classes in Sydney (cohort design) 408 DIS DSM-IV 6 weeks Moderate Low Low Any anxiety disorder=16.67%
Rondó 2003 95
Brazil Pregnant women who attended antenatal care in 12 health units and 5 hospitals in Jundiai, São Paulo
865 STAI >40 1st, 2nd and 3rd trimesters Moderate Moderate Low
Anxiety symptoms 1sttrimester=31.7%;2nd trimester=26.5% 3rd trimester=29.2% Trait 1st trimester=52.9%;2nd trimester=45.8% 3rd trimester=44.3%
Ross 2003 96 Canada
Pregnant women attending a university affiliated obstetric or midwifery clinics in Toronto (cohort design)
150 BSI Top 10% anxiety subscale
3rd trimester 6 and 16 weeks
Moderate Moderate Low Anxiety symptoms 3rd trimester=10% 6 weeks=7.3%; 16 weeks=8.7%
Zar 2002 97 Sweden Pregnant women attending nine obstetric clinics in Jönköping 453 ADIS-
R DSM-IV 3rd trimester Moderate Low Low Generalized anxiety=0.9%
McMahon 2001 98 Australia
Postpartum women from the residential care unit of a parentcraft hospital and a comparison group from a private obstetric practice (cohort design)
186 STAI > 40 16-22 weeks Moderate Moderate Low
Anxiety symptoms Residential care mothers=35% Comparison mothers=9%
9
ADIS-R, Anxiety Disorder Interview Schedule-Revised AKUADS, Aga Khan University Anxiety Depression Scale AUDADIS-IV, Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV BAI, Beck Anxiety Inventory BSI, Brief Symptom Inventory CCEI, Crown-Crisp Experiential Index CIDI, Composite International Diagnostic Interview CIS-R, Clinical Interview Schedule Revised DASS, Depression, Anxiety and Stress Scales DIS, Diagnostic Interview Schedule DSSI, Delusions-Symptoms-States Inventory EPDS, Edinburgh Postnatal Depression Scale HADS, Hospital Anxiety and Depression Scales HSCL, Hopkins Symptoms Checklist GADS, Generalized Anxiety Disorder Scale GDAS, Goldberg Depression and Anxiety Scales IPAT, IPAT Anxiety Scale (Self-Analysis Form) MINI, Mini-International Neuropsychiatric Interview PRAQ, Pregnancy-related Anxiety Questionnaire PRIME-MD Primary Care Evaluation of Mental Disorders PSEI, Prenatal Social Environment Inventory PHQ, Patient Health Questionnaire SAS, Zung Self-Rating Anxiety Scale SCL, Symptom Distress Checklist SCID, Structured Clinical Interview for DSM Disorders STAI, State-Trait Anxiety Inventory
Teixeira 1999 99 UK Pregnant women attending parent craft
classes in London 100 STAI > 40 3rd trimester (M=32weeks) High Moderate Low Anxiety symptoms=15%
Trait=32% Stuart 1998 100
USA Postpartum women from a local county in Iowa (cohort design) 107 BAI >10 14 and 30
weeks Moderate Moderate Low Anxiety symptoms 14 weeks=8.7%; 30 weeks=16.8% 14-30 weeks=10.3%
Bhagwanani 1997 101 USA Pregnant women attending a prenatal clinic
at a hospital in Cleveland (cohort design) 88 STAI > 46 All trimesters Moderate Moderate Low Anxiety symptoms=19.3%
Crandon 1979 102 UK Pregnant women - Not reported 146 IPAT > 7 3rd trimester Moderate Moderate Low Anxiety symptoms=23.3%
10
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17
Figure DS1: Prevalence of antenatal and postnatal (1-24 weeks) any anxiety disorder
18
Figure DS2: Prevalence of antenatal and postnatal (1-24 weeks) generalised anxiety
19
Figure DS3: Prevalence of postnatal anxiety symptoms (1-24 weeks)