Oral Presentation Australasian Diabetes in Pregnancy Society and Society of Obstetric Medicine Australia and New Zealand Joint Scientific Meeting 2021

Depression and anxiety in women 6 months after hypertensive pregnancy: a Blood Pressure Postpartum (BP2) sub-study (#43)

Virginia Su 1 , Lynne Roberts 2 3 , Franziska Pettit 3 4 , Megan Gow 1 2 , Amanda Henry 1 2
  1. School of Women’s and Children’s Health, UNSW Medicine and Health, Sydney, NSW, Australia
  2. Department of Women’s and Children’s Health, St George Hospital, Sydney, NSW, Australia
  3. St George and Sutherland Clinical School, UNSW Medicine and Health, Sydney, NSW, Australia
  4. Department of Renal Medicine, St George Hospital, Sydney, NSW, Australia

Background/Objectives:

Hypertensive disorders of pregnancy (HDP) have been associated with postpartum mental health sequelae. However, limited evidence exists on how this risk may differ between subgroups. This sub-study aimed to compare mental health (depression and anxiety) between Blood Pressure Postpartum (BP2) subgroups at baseline (6-months postpartum).

 

Methods:  

Sub-study of the in-progress BP2 study, a randomised controlled trial investigating lifestyle interventions after HDP. Data obtained approximately 6-months postpartum from BP2 pre-randomisation questionnaires, including the Edinburgh Postnatal Depression Scale (EPDS) and General Anxiety Disorder 7-item scale (GAD-7). Major subgroups compared included (a) Type of HDP (preeclampsia PE, gestational hypertension GH, chronic hypertension CH ± superimposed preeclampsia PE+CH), (b) BMI (<30, ≥30), (c) primiparous versus multiparous and (d) preterm versus term birth.

 

Results:

212 women (29 CH, 57 GH, 113 PE and 14 PE+CH) randomised to August 2020. In the overall cohort, 2% had a non-zero answer to Q10 (suicidal ideation) on the EPDS, 10% scored above the EPDS cut-off (>12) and 5% scored above the GAD-7 cut-off (>10) at 6-months postpartum. In comparing HDP subtypes, 22% PE+CH scored above the GAD-7 cut-off compared to 7% CH, 5% GH and 3% PE (p=0.023). A higher proportion of PE+CH (14%) expressed any suicidal ideation on the EPDS compared to 0% CH, 2% GH and 2% PE (p=0.023). Women with BMI ≥30 (18%) scored above the EPDS cut-off compared to women with BMI <30 (7%, p=0.01). No significant differences were noted by parity or term versus preterm birth.

 

Conclusions:

Women with previous PE+CH and/or BMI ≥30 appear more at risk of depression and anxiety than other women post-HDP. This has implications in guiding postpartum management, including increased screening and additional psychological follow-up. Further research, including examination of confounders, is needed to strengthen these conclusions.