# 2/2 Predictors and Course of Postpartum Obsessions and Compulsions

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2022 · $379,928

## Abstract

Project Summary/Abstract
Obsessional anxiety and compulsive rituals arising during pregnancy and the postpartum have a
significant detrimental short-term impact on the well-being of the mother, the pregnancy, the
unborn child, and the newborn infant. They also can have negative long-term effects on maternal
and infant health, as well as on the mother-infant relationship and on into childhood. Although
research has focused on perinatal depressive and anxious states, there is now strong evidence
that obsessions and compulsions (OCS) are precipitated or exacerbated by pregnancy and
childbirth and may have a deleterious impact on mother and infant. Despite an increased risk of
developing OCS during pregnancy and postnatally (i.e., the perinatal period), there is almost no
empirical research on its predictors and precursors, how it is related to other postpartum negative
valence states such as anxiety and depression, or the specific impact of postpartum OCS on the
mother. Accordingly, we will prospectively examine the predictive utility of psychological and
biological phenomena (e.g., self-report, physiology) empirically linked to perinatal/postpartum
OCS (pOCS), anxiety, and depression, and how these states relate with one another. We also
aim to evaluate the extent to which pOCS manifest adverse effects on functionally-related
outcomes of significant public health concern, such as obstetric outcomes, maternal health,
maternal attitudes, and parenting behaviors during the first year of life. Consistent with the
Research Domain Criteria (RDoC) framework, women will be screened antenatally for diatheses
empirically demonstrated to predispose to the development or exacerbation of pOCS; and that
are thus hypothesized to also put one at risk for pOCS. High- and low-risk groups will be followed
during pregnancy and for 6 months postpartum, and repeatedly assessed to identify those
experiencing more frequent, intense, and prolonged pOCS and the variables associated with such
problems. The two recruitment sites for this study are the University of North Carolina (UNC) at
Chapel Hill and Johns Hopkins University (JHU). JHU will provide data management and analytic
support. Considering estimates of the high rates of pOCS, together with the limited available
information on this subject, the results of this study will help clinicians and researchers 1) use
psychological and biological markers elucidated in the current study to identify women at
increased risk of developing OCD and its adverse consequences, and 2) reduce the risk of
developing OC symptoms in pregnancy, and its adverse consequences, by modifying these
psychological and biological factors prior to pregnancy, and in the early prenatal period. Moreover,
the risk factors elucidated in this study may be applicable to development of non-pregnancy-
related OC symptoms.

## Key facts

- **NIH application ID:** 10405446
- **Project number:** 5R01MH118261-04
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** GERALD NESTADT
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $379,928
- **Award type:** 5
- **Project period:** 2019-07-15 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10405446

## Citation

> US National Institutes of Health, RePORTER application 10405446, 2/2 Predictors and Course of Postpartum Obsessions and Compulsions (5R01MH118261-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10405446. Licensed CC0.

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