The long-term course of perinatal anxiety: A systematic review and meta-analysis protocol.

Abstract

The perinatal period represents a high-risk period for anxiety, with symptoms of anxiety associated with a range of adverse outcomes for birthing people and children. Previous reviews have assessed the prevalence of anxiety during the perinatal period. However, the long-term course of perinatal anxiety remains unclear. This review protocol aims to investigate the long-term, natural course of anxiety symptoms, anxiety disorders, and anxiety-related disorders (AAARDS) among birthing people. A systematic review and, if appropriate, meta-analysis will be conducted according to the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Search terms will be applied to the following databases: MEDLINE, EMBASE, CINAHL, Web of Science, and PsycINFO. Inclusion criteria will be: (1) prevalence of AAARDS assessed at least once during the perinatal period and at ≥24 months post-birth, (2) AAARDS assessed using a validated measure and/or diagnostic interview, (3) full-text available online. Exclusion criteria will be: (1) grey literature, (2) qualitative, interventional, or animal studies, (3) studies with a selected sample, (4) studies with a small sample size (N < 10), and (5) studies that synthesise existing research. Screening and data extraction will be conducted by two independent reviewers, with any conflicts resolved by a third reviewer. Risk of bias will be assessed using a modified version of the Downs and Black checklist. Data will be narratively synthesised, and meta-analyses will be conducted where appropriate. The present protocol describes the methodology for a systematic review investigating the long-term course of perinatal AAARDS. Findings will address a gap in the literature and enhance our understanding of the natural course of perinatal anxiety, which could help to inform clinical services and resource allocation. This review has been registered on PROSPERO (registration code: CRD420251073221).