Obstetrician -gynecologists' screening patterns and decision -making strategies for anxiety during pregnancy

As obstetrician-gynecologists (ob-gyns) take on a greater role in women's healthcare, it is important that they are aware of the high prevalence rate of anxiety disorders in their patient population. Anxiety disorders present during pregnancy can have detrimental effects on both mother and child, such as low infant birth weight, spontaneous preterm labor, and negative behavioral reactivity in infancy. In the present study, we surveyed 1,193 ob-gyns on their screening rates, practice patterns, training, knowledge, and decision-making strategies as they relate to anxiety disorders during pregnancy. We achieved a 44% response rate after three mailings. Physicians reported a moderate interest in screening and diagnosing anxiety, but less interest in treatment. Only 20% of respondents screen for anxiety during pregnancy, although having a friend who has been diagnosed with an anxiety disorder significantly increased ob-gyns' anxiety screening rates as well as the reported level of interest in screening for anxiety during pregnancy. Ob-gyns typically refer anxiety-disordered patients to mental health professionals. This may be related to the finding that the majority of ob-gyns feels that their training in this area was barely adequate to inadequate. Generally, ob-gyns are more knowledgeable about depression and depressive symptoms than anxiety disorders. Specifically, generalized anxiety disorder may be the least understood. Increased training in this area would allow ob-gyns to overcome what they list as a primary barrier to anxiety screening during pregnancy---that is, inadequate training about anxiety disorders. Only 30% of respondents have completed continuing medical education courses on anxiety disorders screening. Education efforts should be targeted to conferences, professional publications, and peer-reviewed journals, as these were reported as preferred methods of training for anxiety-related topics.