The course of panic disorder during the peripartum period and the risk for adverse child development: A prospective-longitudinal study

•Heterogeneous course patterns of PD were observed during the peripartum period.•PD/panic attacks were commonly observed during the early stages of pregnancy.•Comorbid PD and MD was the worst condition (impaired bonding, regulatory problems). Panic disorders during pregnancy and after delivery may have detrimental effects for mother and child, but no firm conclusions regarding the course and outcomes of peripartum panic disorders can be drawn from previous studies. N = 306 women were repeatedly interviewed with the Composite International Diagnostic Interview for Women. Social support and partnership quality, gestational outcomes, duration of breastfeeding, regulatory disorders, maternal bonding and parenting style were assessed via medical and maternal reports. Standardized observations of neuropsychological development, infant temperament and attachment were conducted 4 and 16 months after delivery. Women reported heterogenous courses of panic disorders, and panic disorders/panic attacks were commonly observed during the early stages of pregnancy. Women with peripartum panic disorders presented with a worse psychosocial situation (e.g., lower social support). Clear behavioral differences (temperament, attachment) in infants of women with panic disorders as compared to women with no anxiety and depressive disorder could not be detected in this study, but differences concerning gestational outcomes, duration of breastfeeding, maternal parenting, and bonding as well as regulatory problems in infants were identified. This prospective-longitudinal multi-wave study is restricted by the relative small sizes of the particular groups that limit the power to detect group differences. Heterogenous courses and outcomes of perinatal panic disorders require intensive monitoring of affected mother-infant-dyads who may benefit from early targeted interventions to prevent an escalation of dyadic problems.