Factors Associated with Significant Anxiety and Depressive Symptoms in Pregnant Women with a History of Complications

Shanghai Arch Psychiatry. 2016 Oct 25;28(5):253-262. doi: 10.11919/j.issn.1002-0829.216035.

Abstract

Background: The occurrence of complications during the gestation period is higher among pregnant women with a history of complications than among pregnant women without previous complications. High-risk pregnancy can cause negative emotional symptoms such as anxiety and depression in pregnant women. Current research on anxiety and depression symptoms in pregnant women is sparse.

Aims: To examine the incidence of anxiety and depression symptoms in pregnant women with a history of previous complications or high risk pregnancy and related risk factors.

Methods: Women with a history of previous complications in pregnancy or current 'high risk' pregnancy (e.g. test tube fertilization, etc.) were classified as 'high risk'. 197 of these 'high risk' women who were in their second trimester (16 to 20 weeks) underwent a monthly comprehensive assessment using the Hospital Anxiety and Depression Scale (HAD) in the last 4 months of the gestation period. The Edinburgh Postnatal Depression Scale (EPDS) was used for assessment and risk factor investigation 3 to 7 days, 42 days, and 3 months after childbirth.

Results: The mean (sd) HAD anxiety score among 'high-risk'women at the time of enrollment was 3.69 (2.76) and depression score was 3.42 (2.53). Significant anxiety symptoms and depression symptoms were found in 14 cases (7.18 %) and 10 cases (5.13%), respectively. Multivariate analysis showed a correlation between anxiety symptoms and history of miscarriage (OR: 8.162, 95%CI: 1.213 to 54.914)and testing positive for hepatitis (OR: 8.912, 95%CI: 1.052 to 75.498). Depressive symptoms were correlated with glucose positive urine (OR: 30.529, 95%CI: 1.312 to 710.610) and history of hemorrhaging (OR: 7.122, 95%CI: 1.015 to 49.984). General factors associated with anxiety and depression symptoms include patients' health status in the recent 3 months, concerns about fetal health, quality of marital relationship, and relationship with in-laws.

Conclusions: Anxiety and depression symptoms are commonly seen in pregnant women with a history of previous complications or current 'high risk' pregnancy. Patients' recent health status, relationship with in-laws, marital quality and concerns about fetal health are associated with anxiety and depression symptoms during pregnancy.

背景: 高危孕妇与普通孕妇相比在妊娠期会出现更多的并发症,高危因素作为一种应激因素更易诱发孕妇产生焦虑、抑郁等负面情绪症状。目前国内外对高危孕妇焦虑、抑郁症状的研究相对较少。.

目标: 调查产科高危妊娠孕妇焦虑、抑郁症状发生率及其相关危险因素。.

方法: 对197 例孕中期(16-20 周)的高危孕妇在妊娠最后4 月每月进行综合性医院焦虑/ 抑郁量表(HAD)评估和风险因素调查。产后3-7 天、42 天及3 月进行爱丁堡产后抑郁量表(EPDS)评估和风险因素调查。.

结果: 入组时高危孕妇HAD 焦虑均分:3.69(2.76),抑郁均分:3.42 (2.53)。焦虑症状14 例(7.18%),抑郁症状10 例(5.13%)。多因素分析显示,怀孕有无保胎(OR:8.162, 95%CI:1.213-54.914)和乙肝阳性(OR:8.912, 95%CI:1.052-75.498)与焦虑症状相关。尿糖阳性(OR: 30.529, 95%CI:1.312-710.610)和既往出血史(OR:7.122, 95%CI:1.015-49.984)与抑郁症状相关。孕期影响高危孕妇焦虑、抑郁症状的因素有:近3 月孕妇健康状况、担心胎儿健康、夫妻关系、婆媳关系等。.

结论: 高危妊娠孕妇焦虑、抑郁症状较常见。近3 月孕妇健康状况、婆媳关系、夫妻关系、担心胎儿健康是高危孕妇孕期焦虑、抑郁症状的风险因素。.

Keywords: anxiety; depression; high-risk pregnancy.