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Psychological disorders in pregnant mothers linked to preeclampsia, data show

Tuesday, April 14 2009 | Comments

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What's This? A new study suggests that mothers with mood and/or anxiety disorders before or during early pregnancy are at increased risk for preeclampsia.

Past research has produced conflicting results about whether there is an association between maternal mood/anxiety disorders and preeclampsia risk, so researchers conducted a new study to clarify the issue as well as to determine any link with psychotropic drug use.

They analyzed data from Omega, an ongoing prospective cohort study that is examining risk factors for preeclampsia. A total of 2,601 women completed questionnaires and made their and their infants' medical records available.

Medical records confirmed that 136 women (5.2%) had a diagnosis of depression, bipolar disorder, or anxiety disorder before pregnancy (n=106) or by 20 weeks of gestation (n=30). Approximately 87.5% (n=119) of the women with such a diagnosis used some psychotropic medication during pregnancy.

The investigators found that any mood or anxiety disorder increased the risk for preeclampsia by 2.86-fold (95% CI, 1.42-5.78; P=.003) when compared with women without a psychological condition. The association lessened after adjustments for maternal age, race/ethnicity, and prepregnancy body mass index (relative risk [RR], 2.12; 95% CI, 1.02-4.45; P=.045).

The increased risk appeared to be greater and significant in women who received the mood/anxiety disorder diagnosis early in pregnancy (vs women without the condition: RR, 3.64; 95% CI, 1.13-11.68; P=.030) than in those who had the diagnosis before becoming pregnant (vs women without the condition: RR, 1.73; P=NS).

Women who took psychotropic drugs were also more likely to develop preeclampsia (RR, 2.38; 95% CI, 1.13-5.00; P=.023).

Finally, the preeclampsia risk factors of advanced maternal age, nulliparity, prepregnancy overweight status, physical activity during pregnancy, and positive family history of hypertension did not significantly alter the association between psychological diagnosis and preeclampsia risk.
 
"Collectively, available data suggest that comprehensive efforts are required to characterize reproductive sequelae of psychiatric illnesses carefully among reproductive aged and pregnant women," the study authors concluded. (Qiu C, et al. Am J Hypertens 2009;22:397-402.)

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