Does hypertension in pregnancy impact the woman's mental health?

Abstract

Introduction: Pregnancy and childbirth may lead to increased rates of depression, anxiety and posttraumatic stress disorder (PTSD) in women and the likelihood may be greater for those who have perinatal complications. There is some evidence that hypertension in pregnancy (HIP) might be linked to depression, anxiety and PTSD symptoms. However, it is uncertain whether the cause of the mental health problem is the hypertensive disorder, the sequelae of this complication (eg. preterm birth, baby requiring specialised care) or whether these issues pre-dated the pregnancy. We are undertaking a prospective study to explore this issue. Aim: To identify women who may have increased risk of depression, anxiety and PTSD following the birth of their baby. Methods: Eligible, consenting women who had either hypertension (gestational or preeclampsia) or normal blood pressure in pregnancy, complete the Edinburgh Postnatal Depression scale (EPDS),the General Anxiety Disorder scale and the Post-traumatic Stress Diagnostic Scale at 6months postpartum. Results: 136 women have completed the questionnaires, 31 had HIP. The women with HIP scored slightly higher than the normotensive group in all domains. EPDS score >12 in 10% versus 6%, moderate anxiety reported by 7% versus 4%, and PTSD symptoms reported by 55% versus 38%. In both groups, 3% met PTSD criteria, however all were unrelated to the pregnancy or birth experience. Conclusion: The study is in early stages but potentially suggests more mental health problems in the HIP group. If this effect continues, the antenatal and postnatal care a woman receives for HIP should also focus on mental health issues not only physical health.