Associations of anxiety disorders, depressive disorders and body weight with hypertension during pregnancy

Abstract

The purpose of this study was to prospectively examine the relationships between maternal DSM-IV-TR anxiety disorders, depressive disorders, and body mass index (BMI) with arterial hypertension and blood pressure during pregnancy. In the Maternal Anxiety in Relation to Infant Development (MARI) study, N = 306 women were enrolled in early pregnancy and repeatedly assessed during peripartum period. DSM-IV-TR anxiety and depressive disorders prior to pregnancy, lifetime anxiety/depression liability, and BMI during early pregnancy were assessed with the Composite International Diagnostic Interview for Women (CIDI-V). Based on their prepregnancy status, all participants were assigned to one of the following initial diagnostic groups: no anxiety nor depressive disorder (no AD), pure depressive disorder (pure D), pure anxiety disorder (pure A), and comorbid anxiety and depressive disorder (comorbid AD). Blood pressure measurements were derived from medical records. Arterial hypertension during pregnancy was defined by at least two blood pressure values ≥140 mmHg systolic and/or ≥90 mmHg diastolic. N = 283 women with at least four documented blood pressure measurements during pregnancy were included in the analyses. In this sample, N = 47 women (16.6 %) were identified with arterial hypertension during pregnancy. Women with comorbid AD (reference group: no AD) had a significantly higher blood pressure after adjustment for age, parity, smoking, occupation, household income, and education (systolic: linear regression coefficient [β] = 3.0, 95 % confidence interval [CI] = 0.2-5.7; diastolic, β = 2.3, 95 % CI = 0.1-4.4). Anxiety liability was associated with an increased risk of hypertension (odds ratio [OR] = 1.1, 95 % CI = 1.0-1.3) and a higher systolic blood pressure (β = 0.4, 95 % CI = 0.0-0.7). The adjusted interaction model revealed a significant interaction between the diagnostic group pure A and BMI for hypertension (ORIT = 1.5, 95 % CI = 1.1-2.1). Especially, women with a lifetime history of comorbid anxiety and depression and obese pregnant women with a lifetime history of pure anxiety disorder should be informed about their heightened risk of hypertension, monitored with regular blood pressure measurements, and provided with strategies for prevention and early intervention such as changes in diet and physical activity.

Therapist-Supported Internet-Based Cognitive Behavior Therapy for Stress, Anxiety, and Depressive Symptoms Among Postpartum Women: A Systematic Review and Meta-Analysis

“…Depressive symptoms were measured through the Beck Depression Inventory-II [54], Edinburgh Postnatal Depression Scale [55], and BSI-GSI [51]. iCBT interventions in this meta-analysis exerted a significant effect on improving depressive symptoms (Z=9.42, P <.001) with medium to large effect size of 0.63 (Figure 5).…”

Anxiety among women experiencing medically complicated pregnancy: A systematic review and meta‐analysis

“…Medical complications impact not only the health and well‐being of the mother but also her developing infant (and the entire family). For example, diseases such as preeclampsia and gestational diabetes have a strong association with high maternal morbidity, hospitalization, birth complications, and neonatal mortality …”

“…For example, diseases such as preeclampsia and gestational diabetes have a strong association with high maternal morbidity, hospitalization, birth complications, and neonatal mortality. 19 Aside from the physical implications, a medically complicated pregnancy can also be a source of significant stress and anxiety for mothers. [20][21][22][23] Medical complications of pregnancy can invoke stressful emotional postpartum responses in parents which differ from the usual stresses associated with parenthood.…”

Maternal Uncontrolled Anxiety Disorders Are Associated With the Increased Risk of Hypertensive Disorders in Japanese Pregnant Women

“…Studies of the non-pregnant populations have shown that these mental disorders are associated with the development of hypertension [ 1-3 ]. In particular, individuals with depressive and anxiety disorders may be more prone to hypertension because of a presumed unhealthy lifestyle and associated changes in the autonomic nervous system, the hypothalamic-pituitary adrenal axis, and the immune system [ 3-5 ].…”