From the Department of Psychology (Horsley and Ditto), Faculty of Science, McGill University, Montreal, Quebec; Department of Psychology (Tomfohr-Madsen), Faculty of Arts, University of Calgary, Alberta; and Department of Pediatrics and Community Health Sciences (Tough), Cumming School of Medicine, University of Calgary, Alberta, Canada.
Psychosom Med. 2019 Jun;81(5):458-463. doi: 10.1097/PSY.0000000000000695.
The aim of the study was to investigate whether symptoms of depression or state anxiety changed the strength or nature of the association between hypertensive disorders of pregnancy (HDP) and gestational age at birth.
We conducted a secondary analysis of data from the All Our Families Cohort, a prospective pregnancy cohort study based in Calgary, Alberta, Canada. Self-reported depressive symptoms and state anxiety were assessed between 3 and 5 months of gestation, and obstetrical information, including diagnosis of HDP, parity, type of delivery, and gestational age at birth, was retrieved from the maternal discharge abstract. All models were adjusted for sociodemographic and obstetric confounders.
Of 2763 women who had a singleton pregnancy and live birth, 247 (9%) were diagnosed with HDP. Women with HDP had significantly shorter gestational length relative to those without the diagnosis (M = 37.87 versus M = 38.99 weeks of gestation), t(2761) = 9.43, p < .001. Moderation analyses showed significant HDP by depressive symptoms and HDP by state anxiety interactions, such that the strength of the association between HDP and gestational age at birth increased alongside greater depressive symptom and state anxiety severity.
Results suggest that depressive symptoms and state anxiety may add to the increased risk for shortened gestation associated with HDP. Women at high risk of cardiovascular complications during pregnancy may benefit from additional resources to manage symptoms of depression or anxiety.
本研究旨在探讨抑郁症状或状态焦虑是否改变了妊娠高血压疾病（HDP）与出生时胎龄之间的关联强度或性质。
我们对来自加拿大阿尔伯塔省卡尔加里市的全国家庭队列前瞻性妊娠队列研究的数据进行了二次分析。在妊娠 3 至 5 个月时评估了自我报告的抑郁症状和状态焦虑，并且从产妇出院摘要中检索了包括 HDP 诊断、产次、分娩类型和出生时胎龄在内的产科信息。所有模型均针对社会人口统计学和产科混杂因素进行了调整。
在 2763 名有单胎妊娠和活产的女性中，有 247 名（9%）被诊断为 HDP。与未诊断出 HDP 的女性相比，患有 HDP 的女性的妊娠长度明显缩短（M=37.87 与 M=38.99 周），t（2761）=9.43，p<.001。调节分析显示，HDP 与抑郁症状以及 HDP 与状态焦虑之间存在显著的交互作用，即 HDP 与出生时胎龄之间的关联强度随着抑郁症状和状态焦虑严重程度的增加而增加。
结果表明，抑郁症状和状态焦虑可能会增加与 HDP 相关的早产风险。在妊娠期间有心血管并发症高风险的女性可能需要额外的资源来管理抑郁或焦虑症状。
