Major Gaps Exist Around Knowledge of Postpartum Anxiety

Understanding postpartum mental disorders, including postpartum anxiety (PPA), requires mothers, providers and social support networks to recognize the signs and symptoms. However, limited studies and a lack of a unified definition of PPA make this challenging. Researchers from Mass General Brigham conducted a comprehensive literature review of 850 PPA studies to summarize the collective knowledge of PPA and identify knowledge gaps. They found PPA may be almost as common as postpartum depression, affecting 12.3% of mothers worldwide, and is associated with changes in offspring biology and mental health, as well as worse psychological outcomes and quality of life for mothers.

“PPA is associated with changes in children’s health and development, mental health and worse psychological outcomes and quality of life for mothers,” said lead author Natalie Feldman, MD, from the Department of Psychiatry at Brigham and Women’s Hospital, a founding member of the Mass General Brigham healthcare system. “However, there are major gaps in our understanding of this condition, particularly around key symptoms and whether treatments are effective. The reality is that everyone knows someone who has had PPA—but we aren’t talking about it.”

The literature review found that younger moms, first-time moms and those with traumatic births or C-sections are at an increased risk of developing PPA, suggesting clinicians can connect these high-risk groups to targeted interventions earlier.

The authors also found symptoms such as excessive worry, intrusive thoughts, and problems with sleep were common among individuals with PPA. Cognitive Behavioral Therapy shows promise as an effective intervention, whether conducted in group, individual or prenatal sessions.

“The time to rigorously and thoroughly study PPA is now so we can improve how we care for patients,” said Feldman.

Authorship: In addition to Feldman, Mass General Brigham authors include Leena Mittal, Pamela Wiegartz, David Silbersweig, and Cindy H Liu. Additional authors include Alice Hibara, Jamie Ye, Anjeli Macaranas, Piper Larkin, Erin Hendrix, and Taline Aydinian.

Disclosures: Silbersweig has received Grand Rounds honoraria from academic medical centers, has neuroimaging patents that are not related to the topic of this manuscript, holds stock in unrelated companies, is a co-founder and SAB Chair of Ceretype Neuromedicine, and serves on the Board of the Spaulding Rehabilitation Network. Mittal has received consulting fees from Carelon/Mass Behavioral Health Partnership and has provided expert testimony to Wilmer Hale on behalf of Planned Parenthood. Feldman has owned a small amount of stock in Moderna and J&J within the past 36 months.

Paper cited: Feldman NF et al. “Postpartum Anxiety: A State-of-the-Art Review” Lancet Psychiatry DOI: 10.1016/S2215-0366(25)00197-X