To systematically review the prevalence and mean anxiety symptom scores among women who conceived following ART, from confirmed pregnancy until 12 months postpartum, compared to women who conceived without ART (spontaneous conception, SC).
Approach:
Search Strategy: Searched MEDLINE, PsycINFO, and EMBASE from their start dates to 3rd June 2024 using keywords related to ART, anxiety symptoms, pregnancy, and postnatal period.
Study Inclusion: Twenty studies met inclusion criteria, including cohort (n=15), case-control (n=1), and cross-sectional (n=4) designs.
Data Extraction: Extracted data on prevalence and mean anxiety symptom scores in ART and SC groups, along with study characteristics.
Key Findings:
Most studies during the first (n=3) and second trimester (n=8) reported non-significant differences in anxiety symptoms between ART and SC groups, except for one second trimester study that reported elevated pregnancy-specific anxiety symptoms in the ART group.
Mixed findings were observed in the third trimester (n=16) and postnatal period (n=8), with some studies reporting higher (T3:n=4; postnatal:n=2), lower (T3:n=1; postnatal:n=2), or no significant differences (T3:n=9; postnatal:n=4) in anxiety symptoms in the ART group.
Interpretation:
Some studies indicated elevated anxiety symptoms following ART, particularly in late pregnancy and postpartum, but findings remain mixed.
Limitations:
The review highlights the need for further longitudinal research to understand the postpartum experiences of women with fertility difficulties, particularly focusing on anxiety symptom trajectories.
Conclusion:
Further longitudinal research is warranted to better understand the postpartum experiences of women with fertility difficulties.
