The efficacy of cognitive behavior therapy for the treatment of perinatal anxiety symptoms: A preliminary meta-analysis

Abstract

Cognitive-behavior therapy (CBT) is considered the psychological treatment of choice for anxiety disorders in the general population. However the efficacy of CBT for anxiety that occurs during the perinatal period, defined as the period from conception to 12 months post birth, is less understood. Perinatal anxiety is a complex and multifaceted problem that can affect both the pregnant women and the unborn child, as well as the wider family unit. The aim of this study was to synthesize the current empirical status of CBT for perinatal anxiety using a meta-analytic approach. Relevant articles were identified through a search of electronic databases through to June 2018. The search terms used include 'anxiety' or 'phobia' AND 'perinatal' or 'pregnan* or 'postnatal' or 'postpartum' AND 'CBT' or 'cognitive behav* therapy'. Randomized and non-randomized studies were included within the meta-analysis. A total of 13 studies met the inclusion criteria and were included in the meta-analysis. The pooled between-group mean effect size was small at post treatment (k = 7; d = 0.49; 95% CI: 0.08-0.91) favoring the CBT treatments (Q 1 = 30.13, p <.001). Heterogeneity was high (I 2 = 80.09). The pooled within-group mean effect size was large across the treatment groups from pre-treatment to post-treatment when combining all of the studies (i.e., controlled and uncontrolled studies; k = 14; d = 0.90; 95% CI: 0.63-1.17). Heterogeneity was high (I 2 = 88.55). Some preliminary and exploratory moderator analyses were also conducted to inform potential future research in this field.