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Hypertensive disorders of pregnancy prevalent in mothers with anxiety, depression

18 Nov 2020

Most women who go through depression or have anxiety during pregnancy have hypertensive disorders of pregnancy (HDP), according to the results of a meta-analysis, which highlights a strong link between the mental and the obstetric disorders.

The meta-analysis included 44 studies across 61.2 million pregnancies. These studies examined the risk of HDP in the presence or absence of clinically significant symptoms or a medical record diagnosis of depression or an anxiety disorder during pregnancy.

Fourteen of the studies evaluated pre-eclampsia, five assessed gestational hypertension, and 25 looked at a combined outcome that included both gestational hypertension and pre-eclampsia or broadly categorized all cases as ‘HDP’.

Many studies considered other relevant covariates in addition to body mass index (BMI), such as sociodemographic information (eg, maternal age, ethnicity, education, income, and marital status), obstetrical information (eg, parity, pregnancy complications, and gestational age), health-related behaviors (eg, tobacco use), and health information such as diabetes (including gestational), previous history of hypertension (including pregnancies), and antidepressant/anxiolytic medication use.

Pooled data revealed that exposure to clinically significant symptoms of depression or anxiety or a diagnosis of either condition in pregnancy contributed to about a 40-percent increased odds of a diagnosis of HDP (relative risk [RR], 1.39, 95 percent confidence interval [CI], 1.25–1.54).

The association remained significant in analyses limited to studies evaluating depression only (26 studies; RR, 1.30, 95 percent CI, 1.19–1.43) and those assessing anxiety only (10 studies; RR, 1.49, 95 percent CI, 1.13–21.98).

In light of the findings, healthcare providers should be attentive to mental health concerns among women diagnosed with HDP.

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