Depression, anxiety predict hypertensive disorders of pregnancy

Pregnant women with depression or anxiety are at risk of having hypertensive disorders of pregnancy (HDP), a study has found.

Researchers conducted a systematic review and meta-analysis of studies examining the prevalence of depression and/or anxiety in pregnancy in relation to the risk of HDP. They searched multiple online databases and identified 4,275 papers, of which 44 were eligible for synthesis.

The eligible studies were published between 2000 and 2020 and yielded a total sample of about 61,203,967 women. Fourteen studies evaluated pre-eclampsia, five examined gestational hypertension, 25 used a combined outcome that included both gestational hypertension and pre-eclampsia or broadly categorized all cases as HDP. In terms of mental health variables, 23 focused on depression alone, 11 looked at the combination of depression and anxiety, eight studied anxiety alone, and the last two included women with either anxiety or depression or other disorders.

Pooled data showed that pregnant women with clinically significant symptoms of depression or anxiety or diagnosed with depression or anxiety disorder were more likely to have HDP compared with their counterparts who did not have the mental disorders (relative risk [RR], 1.39, 95 percent confidence interval [CI], 1.25–1.54).

The risk increase was observed even in the subgroup of women who received a diagnosis or had self-reported clinically significant symptoms of depression or an anxiety early in their pregnancies (<20 weeks of gestation; RR, 1.27, 95 percent CI, 1.07–1.50).

In light of the findings, the researchers emphasized the importance of being alert to mental health during pregnancy in order to identify, support, and treat those at risk of or who have been diagnosed with HDP.