JMIR Publications

ABSTRACT

Background:

The peripartum period, defined as the period from the beginning of the gestation until one year after the delivery, has long been shown to be potentially associated with increased levels of stress and anxiety with regard to one’s transition to the status of parent and the accompanying parental tasks. Yet, no research to date has investigated changes in intrapersonal factors during the peripartum period in women at risk for pregnancy induced hypertension (PIH).

Objective:

The aim of this study is to explore and describe changes in intrapersonal factors in patients at risk for PIH.

Methods:

An explorative design is used in which three questionnaires were sent by email to 110 participants the day following inclusion in the Pregnancy Remote Monitoring (PREMOM) program for pregnant women at risk for PIH. Women were invited to complete the questionnaires at the beginning of their participation in the PREMOM project (mostly at 14 weeks of gestation), and after 32 weeks of gestational age (GA). The Generalized Anxiety Disorder scale (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9) were used to assess anxiety and depression; an adaptation of the Pain Catastrophizing Scale (PCS) was used to measure trait pain catastrophizing.

Results:

Scores were significantly higher at 32 weeks of GA, compared to the moment of inclusion (GAD-7: 7 (4-11) vs. 5 (3-8), P = .01; and PHQ-9: 6 (4-10) vs. 4 (2-7), P < .01). The subscale scores of the PCS were all lower at 32 weeks of GA compared with 14 weeks of GA (Rumination: 4 (1 – 6) vs. 5 (2 – 9.5), P = .11; Magnification: 3 (1 – 5.5) vs. 4 (3 – 7), P = .04; and Helplessnes: 5 (2-9) vs. 6 (3.5 – 12), p = .06). The proportion of women with a risk for depression (GAD-7 > 10) was 13.3% at inclusion and had increased to 35.6% at 32 weeks of GA.

Conclusions:

This study shows that pregnant women at risk for PIH have higher levels of stress and anxiety at 32 weeks of GA, compared to the moment of inclusion. Further research is recommended to investigate potential strategies to help pregnant women at risk for PIH to manage feelings of stress and anxiety. Clinical Trial: The study was also registered at clinicaltrails.gov (NCT03246737)