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

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.