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 +/- 0.9 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. (C) 2014 Elsevier Inc. All rights reserved.