Depression and anxiety among high-risk obstetric inpatients☆

Objective To assess the following among women hospitalized antenatally due to high-risk pregnancies: (1) rates of depression symptoms and anxiety symptoms, (2) changes in depression symptoms and anxiety symptoms and, (3) rates of mental health treatment. Methods Sixty-two participants hospitalized for high-risk obstetrical complications completed the Edinburgh Postnatal Depression Scale (EPDS), Generalized Anxiety Disorder 7-item scale (GAD-7) and Short-Form 12 weekly until delivery or discharge, and once postpartum. Results Average length of total hospital stay was 8.3±7.6days for women who completed an initial admission survey ( n =62) and 16.3±8.9 ( n =34), 25.4±10.2 ( n =17) and 35±10.9 days ( n =9) for those who completed 2, 3 and 4 surveys, respectively. EPDS was ≥10 in 27% ( n =17) and GAD-7 was ≥10 in 13% ( n =8) of participants at initial survey. Mean anxiety (4.2±6.5 vs. 5.2±5.1, p =.011) and depression (4.4±5.6 vs. 6.9±4.8, p =.011) scores were lower postpartum compared to initial survey. Past mental health diagnosis predicted depression symptoms [odds ratio (OR)=4.54; 95% confidence interval (CI) 1.91–7.17] and anxiety symptoms (OR=5.95; 95% CI 3.04–8.86) at initial survey; however, 21% ( n =10) with no diagnostic history had EPDS ≥10. Five percent ( n =3) received mental health treatment during pregnancy. Conclusion Hospitalized high-risk obstetrical patients may commonly experience depression symptoms and/or anxiety symptoms and not receive treatment. A history of mental health treatment or diagnosis was associated with depression symptoms or anxiety symptoms in pregnancy. Of women with an EPDS ≥10, >50% did not report a past mental health diagnosis.