Poster Presentation Society of Obstetric Medicine of Australia and New Zealand ASM 2015

Does hypertension in pregnancy impact the woman’s mental health postnatally? (#213)

Lynne M Roberts 1 2 , Caroline E Homer 1 2 , Gregory K Davis 2 3
  1. Faculty of Health, University of Technology, Sydney, NSW, Australia
  2. St George Hospital, Kogarah, NSW, Australia
  3. Faculty of Medicine, University of NSW, Sydney, NSW, Australia

Background:  It has been suggested that pregnancy and childbirth lead to increased rates of depression, anxiety and posttraumatic stress disorder (PTSD) in mothers and the likelihood is greater in women with complications during pregnancy and/or birth. Despite hypertension being the most common medical complication in pregnancy, the literature in this area is limited and inconsistent. There is evidence that hypertension in pregnancy (HIP), particularly the more severe forms, might be linked to depression, anxiety and PTSD symptoms. However, it is uncertain whether the mental health issues are the result of the hypertensive disorder, the sequelae of the HIP, particularly a preterm birth or a baby requiring specialised care, or whether these issues pre-dated the pregnancy. 

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 completed the Edinburgh Postnatal Depression scale (EPDS),  the General Anxiety Disorder scale and the Posttraumatic Stress Diagnostic Scale at six months postpartum.  

Results: This study is in progress. 165 women have completed the questionnaires, 38 had HIP. The HIP group scored slightly, but not significantly, higher compared with the normotensive group in all domains. EPDS score ≥12 in 5% versus 3%, moderate anxiety reported by 5% versus 4%, and PTSD symptoms reported by 34% versus 16%. In both groups, 3% met all the criteria for PTSD, however all cases were unrelated to the pregnancy/birth experience. Four (11%) of HIP women identified the pregnancy/birth experience as a traumatic event, compared to 1(1%) of the normotensive group. 

Conclusion: The study is in early stages but shows more mental health problems in the HIP group. Traditionally, the care a woman receives for HIP focusses on her physical health but if these women are more at risk of mental health problems, their care should include emotional and mental health support.