Anxiety in pregnancy and after giving birth (the perinatal period) is highly prevalent but under-recognised. Robust methods of assessing perinatal anxiety are essential for services to identify and treat women appropriately.

To determine which assessment measures are most psychometrically robust and effective at identifying women with perinatal anxiety (primary objective) and depression (secondary objective).

We conducted a prospective longitudinal cohort study of 2243 women who completed five measures of anxiety and depression (Generalized Anxiety Disorder scale (GAD) two- and seven-item versions; Whooley questions; Clinical Outcomes in Routine Evaluation (CORE-10); and Stirling Antenatal Anxiety Scale (SAAS)) during pregnancy (15 weeks, 22 weeks and 31 weeks) and after birth (6 weeks). To assess diagnostic accuracy a sample of 403 participants completed modules of the Mini-International Neuropsychiatric Interview (MINI).

The best diagnostic accuracy for anxiety was shown by the CORE-10 and SAAS. The best diagnostic accuracy for depression was shown by the CORE-10, SAAS and Whooley questions, although the SAAS had lower specificity. The same cut-off scores for each measure were optimal for identifying anxiety or depression (SAAS ≥9; CORE-10 ≥9; Whooley ≥1). All measures were psychometrically robust, with good internal consistency, convergent validity and unidimensional factor structure.

This study identified robust and effective methods of assessing perinatal anxiety and depression. We recommend using the CORE-10 or SAAS to assess perinatal anxiety and the CORE-10 or Whooley questions to assess depression. The GAD-2 and GAD-7 did not perform as well as other measures and optimal cut-offs were lower than currently recommended.

怀孕期间和产后（围产期）的焦虑非常普遍，但尚未得到充分认识。评估围产期焦虑的可靠方法对于适当识别和治疗妇女的服务至关重要。

确定哪些评估措施在识别患有围产期焦虑（主要目标）和抑郁（次要目标）的妇女方面在心理测量上最稳健、最有效。

我们对 2243 名女性进行了一项前瞻性纵向队列研究，她们完成了五项焦虑和抑郁测量（广泛性焦虑症量表 (GAD) 两项目和七项目版本；胡乱问题；常规评估临床结果 (CORE-10)；和斯特林怀孕期间（15 周、22 周和 31 周）和出生后（6 周）的产前焦虑量表 (SAAS)。为了评估诊断准确性，403 名参与者完成了迷你国际神经精神病学访谈 (MINI) 的模块。

CORE-10 和 SAAS 显示了焦虑症的最佳诊断准确性。尽管 SAAS 的特异性较低，但 CORE-10、SAAS 和 Whooley 问题显示了抑郁症的最佳诊断准确性。每项测量的相同截止分数对于识别焦虑或抑郁是最佳的（SAAS ≥9；CORE-10 ≥9；Whooley ≥1）。所有测量在心理测量上都是稳健的，具有良好的内部一致性、收敛效度和一维因素结构。

这项研究确定了评估围产期焦虑和抑郁的稳健有效的方法。我们建议使用 CORE-10 或 SAAS 来评估围产期焦虑，并使用 CORE-10 或 Whooley 问题来评估抑郁症。 GAD-2 和 GAD-7 的表现不如其他措施，并且最佳截止值低于当前建议的值。