Hypertensive Disorders of Pregnancy and Symptoms of Depression and Anxiety as Related to Gestational Age at Birth: Findings From the All Our Families Study

Abstract

OBJECTIVE: The aim of the study was to investigate whether symptoms of depression or state anxiety changed the strength or nature of the association between hypertensive disorders of pregnancy (HDP) and gestational age at birth. METHODS: We conducted a secondary analysis of data from the All Our Families Cohort, a prospective pregnancy cohort study based in Calgary, Alberta, Canada. Self-reported depressive symptoms and state anxiety were assessed between 3 and 5 months of gestation, and obstetrical information, including diagnosis of HDP, parity, type of delivery, and gestational age at birth, was retrieved from the maternal discharge abstract. All models were adjusted for sociodemographic and obstetric confounders. RESULTS: Of 2763 women who had a singleton pregnancy and live birth, 247 (9%) were diagnosed with HDP. Women with HDP had significantly shorter gestational length relative to those without the diagnosis (M = 37.87 versus M = 38.99 weeks of gestation), t(2761) = 9.43, p < .001. Moderation analyses showed significant HDP by depressive symptoms and HDP by state anxiety interactions, such that the strength of the association between HDP and gestational age at birth increased alongside greater depressive symptom and state anxiety severity. CONCLUSIONS: Results suggest that depressive symptoms and state anxiety may add to the increased risk for shortened gestation associated with HDP. Women at high risk of cardiovascular complications during pregnancy may benefit from additional resources to manage symptoms of depression or anxiety.