The impact of pregnancy and puerperium on panic disorder: a review.

There is little known about the effect of pregnancy and the puerperium on the risk for, and course of anxiety disorders. Initial case reports concerning the relationship between panic disorder (PD) and pregnancy/puerperium suggested that pregnancy protected against PD, while the postpartum period seemed to increase the risk for onset or exacerbation of PD. Later studies have offered a more mixed picture. A computerized search identified eight relevant studies in this area. All were non-controlled and all but one retrospective. Out of the total 215 pregnancies that were described in these studies, 89 (41%) were associated with improvement of PD symptoms during the pregnancy, while 38% of the described pregnancies exhibited onset or exacerbation of PD in the postpartum period. No definite conclusions regarding the effect of pregnancy and puerperium on PD can be drawn from these reviewed studies.