Management of Perinatal Mood and Anxiety Disorders: A Review of Scientific Evidences

AbstractAntenatal stress is a omnipresent clinical challenge with profound implications for multigenerational public health. This review synthesizes evidence regarding the assessment andmanagement of Perinatal Mood and Anxiety Disorders (PMADs), framing pregnancy as asensitive window of biological programming. Assessment strategies have transitioned fromtraditional subjective scales, such as the Perceived Stress Scale, to sophisticated multi-modalevaluations incorporating real-time health monitoring and biological markers, includingsalivary cortisol and epigenetic signatures. The impacts of maternal distress are bifurcated:mothers face increased risks of obstetric complications (e.g., pre-eclampsia and gestationaldiabetes) and long-term cardiovascular pathology, while neonates are at risk for preterm birth,low birth weight, and altered neurodevelopmental trajectories, including Autism SpectrumDisorder, mediated by maternal immune activation. Stress mitigation requires a multi-modalapproach that integrates psychological interventions, such as Cognitive Behavioral Therapy(CBT) and Mindfulness-Based Stress Reduction (MBSR), with innovative care models likegroup prenatal care. Biological management, guided by the CANMAT (Canadian Networkfor Mood and Anxiety Treatment) clinical practice guidelines, emphasizes the balance ofpharmacological risks with the necessity of buffering the physiological stress responsethrough nutritional and medical support. Systemic screening and integrated care are essentialto disrupting the intergenerational transmission of adversity and optimizing health outcomesfor the maternal-infant dyad.