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The prevalence of borderline personality features and borderline personality disorder during the perinatal period: a systematic review and meta-analysis

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Abstract

Borderline personality disorder (BPD) is a psychiatric disorder marked by severe affective instability and poor interpersonal functioning. Existing literature has highlighted that individuals with BPD are at greater risk for a wide range of adverse physiological and psychosocial outcomes in the perinatal period compared to perinatal individuals without BPD. However, to date, no systematic review has addressed the prevalence of BPD and borderline personality features (BPF) in pregnant and postpartum individuals. A systematic review and meta-analysis was conducted by searching three databases (PubMed, PsycINFO, and Embase) on April 6th, 2021. Research articles and conference abstracts that evaluated BPF or BPD in pregnant, postpartum, or mixed perinatal populations were included. Sixteen publications were included in the systematic review (n = 14 research articles, n = 2 conference abstracts), seven of which were included in the meta-analysis. Among non-clinical samples, prevalence rates of BPF during pregnancy ranged from 6.9 to 26.7%, while rates of BPD across the perinatal period ranged from 0.7 to 1.7%. Among clinical samples, rates of BPF and BPD across the perinatal period spanned 9.7–34% and 2.0–35.2%, respectively. Results from the meta-analysis revealed that the pooled prevalence rate of BPD in clinical samples during the perinatal period is 14.0% (95% CI [7.0, 22.0]). Among clinical perinatal samples, there is a high prevalence of borderline personality pathology. This review highlights the need for appropriate validated screening methods to identify and treat BPD in the perinatal population.

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Acknowledgements

Dr. de Azevedo Cardoso acknowledges her postdoctoral fellowship from the Canadian Institutes of Health Research (CIHR).

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Authors and Affiliations

  1. Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada

    Divya Prasad, Nirushi Kuhathasan & Jee Su Suh

  2. Women’s Health Concerns Clinic, St. Joseph’s Healthcare Hamilton, 100 West 5th Street, Suite C124, Hamilton, ON, L8N 3K7, Canada

    Divya Prasad & Benicio N. Frey

  3. Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada

    Nirushi Kuhathasan, Taiane de Azevedo Cardoso, Jee Su Suh & Benicio N. Frey

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  1. Divya Prasad
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  2. Nirushi Kuhathasan
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Correspondence to Benicio N. Frey.

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Prasad, D., Kuhathasan, N., de Azevedo Cardoso, T. et al. The prevalence of borderline personality features and borderline personality disorder during the perinatal period: a systematic review and meta-analysis. Arch Womens Ment Health 25, 277–289 (2022). https://doi.org/10.1007/s00737-022-01218-8

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  • DOI: https://doi.org/10.1007/s00737-022-01218-8

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