Stress, anxiety and depression levels in pregnancy: outpatient versus inpatient.

OBJECTIVE

To compare stress, anxiety and depression levels among 3 groups of pregnant women: 1) low-risk outpatient (LRO), 2) high-risk outpatient (HRO), and 3) inpatient (IP).

METHODS

This was a cross-sectional study using validated instruments. Inclusion criteria were pregnancies 23-37 weeks and maternal age > 18 years. The primary outcome was mean/median scores of Perceived Stress Scale (PSS), State Trait Anxiety Inventory (STAI), and Edinburgh Depression Scale (EDS). Secondary outcome was rate of abnormal scores.

RESULTS

Among 190 women approached, 180 (95%) participated, with 60 (33%) in each group. Mean PSS scores (range 0-40) significantly increased from LRO (12.0, standard deviation [SD] 7.8) to HRO (14.7, SD 7.9) to IP (15.6, SD 8.2);  = .04. Mean STAI scores (range 20-80) also significantly increased from LRO (32.0, SD 11.1) to HRO (35.8, SD 11.9) to IP (40.9, SD 13.1);  < .01. Abnormal anxiety (STAI ≥ 40) was present in 40% of women and significantly higher among IP compared to LRO (56% vs 25%; RR 2.24, 95% CI 1.36-3.67; aRR 2.24, 95% CI 1.34-3.74).

CONCLUSION

Stress and anxiety scores significantly differ in LRO, HRO, and IP women. While depression screening is common postpartum, screening for stress, anxiety and depression prenatally may be beneficial.