posttraumatic stress disorder following adverse life
events or childbirth experiences. However, a large
body of scientific research outside psychiatry
provides extensive information on a wide range of
clinical symptoms during pregnancy, as measured
with screening tools such as the Edinburgh Postpartum
Depression Scale (EPDS), for example, the
Beck Depression Inventory, or the Center for Epidemiological
Studies Depression Scale. Scores on these
measures are sometimes dichotomized in order to
create depressed/nondepressed groups of women as
a proxy for diagnostic categories, but continuous
scores of symptom severity are more often used
in research. Symptoms typically show linear or
dose–response associations with outcomes such
as preterm birth (PTB), low birth weight (LBW), or
infant abnormalities. Our current understanding of
negative affective states in pregnancy is based largely
on these studies of symptomatology, not investigations
of confirmed diagnoses, perhaps because
investigators lacked clinical expertise or funding
to conduct diagnostic interviews. More studies of
confirmed diagnoses would be helpful, particularly
with larger samples and controlling for antidepressant
medications and other relevant variables. Nonetheless,
research findings on symptoms of anxiety
and depression in pregnancy are informative for
clinicians regarding prenatal screening, early detection,
prevention, and treatment of perinatal mood
disturbances among expecting and new mothers.