Depression and anxiety in early pregnancy and risk for preeclampsia

Objective: To examine whether depression and anxiety in early pregnancy are associated with preeclampsia in an unselected nulliparous population. Methods: In this prospective population-based study during pregnancy at out patient maternity clinics in the Helsinki metropolitan area, depression was assessed by a Finnish modification of the short form of the Beck Depressio n Inventory and anxiety by one established question. Preeclampsia was defin ed as elevated blood pressure (BP) (more than 140/100 mmHg) and proteinuria (0.3 g during 24 hours or more). Age, smoking, alcohol consumption, marita l status, socioeconomic status, and bacterial vaginosis were analyzed as po tentially confounding factors in a multiple logistic regression analysis. Results: Six hundred twenty-three consecutive nulliparous women with single ton pregnancies were studied at ten to 17 (median 12) weeks' gestation and at delivery. Of them, 28 (4.5%) women developed preeclampsia. Depression (m ean Beck score 4.5, range 3-17) was observed in 185 (30%), women and anxiet y was observed in 99 (16%) in early pregnancy. In multivariate analysis, af ter adjustment for potentially confounding factors, depression was associat ed with increased risk (odds ratio [OR] 2.5; 95% confidence interval [CI] 1 .1, 5.4) for preeclampsia, as was anxiety (OR 3.2; 95% CI 1.4, 7.4). Either depression or anxiety, or both, were associated with increased risk (OR 3. 1; 95% CI 1.4, 6.9) for preeclampsia. Bacterial vaginosis together with dep ression was associated with increased risk (OR 5.3; 95% CI 1.8, 15.0) for p reeclampsia. Conclusion: Depression and anxiety in early pregnancy are associated with r isk for subsequent preeclampsia, a risk further increased by bacterial vagi nosis. (C) 2000 by The American College of Obstetricians and Gynecologists. )