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Epidemiology of antenatal depression among women with high-risk pregnancies due to obstetric complications: a scoping review

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Abstract

Purpose

Antenatal depression is a common mental health problem among pregnant women that negatively affects maternal and neonatal outcomes. Women with obstetric complications, defined as high-risk pregnancies, seem to be at particularly increased risk for developing depressive symptomatology. The purpose of this study was to review the prevalence of antenatal depression among pregnant women with obstetric complications and to identify possible associated factors.

Methods

A literature search was performed in the PubMed database and a scoping review was conducted to identify studies with data on the prevalence of antenatal depression and associated factors among high-risk pregnancies due to obstetric complications. The included studies were written in English and published up to 31/12/2018.

Results

The prevalence of antenatal depression among pregnant women with high-risk pregnancies ranges from 12.5 to 44.2% among the reviewed studies. The associated factors significantly associated with antenatal depression include maternal age, maternal education, dwelling place, relationship with the partner, previous psychiatric diagnosis, perceived stress, antenatal attachment, abortion thoughts, smoking, diabetes, parity, number of pregnancies, gestational age, threatened preterm labour, preeclampsia and oligohydramnios.

Conclusions

Our findings indicate a high prevalence of depressive disorders in women with obstetric complications, suggesting the need for more rigorous screening among this population. The identification of associated factors also merits clinical attention. Further research is warranted to develop evidence-based effective screening strategies and relevant interventions.

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References

  1. WHO (2008) World Health Organisation. Improving Maternal Mental Health: Millennium Developmental Goal, p 5

  2. Brandon AR, Trivedi MH, Hynan LS, Miltenberger PD, Labat DB, Rifkin JB, Stringer CA (2008) Prenatal depression in women hospitalized for obstetric risk. J Clin Psychiatry 69(4):635–643

    Article  Google Scholar 

  3. Logsdon MC, Wisner KL, Pinto-Foltz MD (2006) The impact of postpartum depression on mothering. J Obstet Gynecol Neonatal Nurs 35(5):652–658. https://doi.org/10.1111/j.1552-6909.2006.00087.x

    Article  PubMed  Google Scholar 

  4. Gotlib IH, Whiffen VE, Mount JH, Milne K, Cordy NI (1989) Prevalence rates and demographic characteristics associated with depression in pregnancy and the postpartum. J Consult Clin Psychol 57(2):269–274

    Article  CAS  Google Scholar 

  5. Austin MP (2004) Antenatal screening and early intervention for "perinatal" distress, depression and anxiety: where to from here? Arch Womens Ment Health 7(1):1–6. https://doi.org/10.1007/s00737-003-0034-4

    Article  PubMed  Google Scholar 

  6. Koutra K, Vassilaki M, Georgiou V, Koutis A, Bitsios P, Chatzi L, Kogevinas M (2014) Antenatal maternal mental health as determinant of postpartum depression in a population based mother-child cohort (Rhea Study) in Crete. Greece Soc Psychiatry Psychiatr Epidemiol 49(5):711–721. https://doi.org/10.1007/s00127-013-0758-z

    Article  PubMed  Google Scholar 

  7. Dagklis T, Papazisis G, Tsakiridis I, Chouliara F, Mamopoulos A, Rousso D (2016) Prevalence of antenatal depression and associated factors among pregnant women hospitalized in a high-risk pregnancy unit in Greece. Soc Psychiatry Psychiatr Epidemiol 51(7):1025–1031. https://doi.org/10.1007/s00127-016-1230-7

    Article  PubMed  Google Scholar 

  8. Dibaba Y, Fantahun M, Hindin MJ (2013) The association of unwanted pregnancy and social support with depressive symptoms in pregnancy: evidence from rural Southwestern Ethiopia. BMC Pregnancy Childbirth 13:135. https://doi.org/10.1186/1471-2393-13-135

    Article  PubMed  PubMed Central  Google Scholar 

  9. Melo EF Jr, Cecatti JG, Pacagnella RC, Leite DF, Vulcani DE, Makuch MY (2012) The prevalence of perinatal depression and its associated factors in two different settings in Brazil. J Affect Disord 136(3):1204–1208. https://doi.org/10.1016/j.jad.2011.11.023

    Article  PubMed  Google Scholar 

  10. Nasreen HE, Kabir ZN, Forsell Y, Edhborg M (2011) Prevalence and associated factors of depressive and anxiety symptoms during pregnancy: a population based study in rural Bangladesh. BMC Womens Health 11:22. https://doi.org/10.1186/1472-6874-11-22

    Article  PubMed  PubMed Central  Google Scholar 

  11. Mohammad KI, Gamble J, Creedy DK (2011) Prevalence and factors associated with the development of antenatal and postnatal depression among Jordanian women. Midwifery 27(6):e238–245. https://doi.org/10.1016/j.midw.2010.10.008

    Article  CAS  PubMed  Google Scholar 

  12. Ritter C, Hobfoll SE, Lavin J, Cameron RP, Hulsizer MR (2000) Stress, psychosocial resources, and depressive symptomatology during pregnancy in low-income, inner-city women. Health Psychol 19(6):576–585

    Article  CAS  Google Scholar 

  13. Alder J, Fink N, Bitzer J, Hosli I, Holzgreve W (2007) Depression and anxiety during pregnancy: a risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature. J Matern Fetal Neonatal Med 20(3):189–209. https://doi.org/10.1080/14767050701209560

    Article  PubMed  Google Scholar 

  14. Grote NK, Bridge JA, Gavin AR, Melville JL, Iyengar S, Katon WJ (2010) A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry 67(10):1012–1024. https://doi.org/10.1001/archgenpsychiatry.2010.111

    Article  PubMed  PubMed Central  Google Scholar 

  15. Hermon N, Wainstock T, Sheiner E, Golan A, Walfisch A (2019) Impact of maternal depression on perinatal outcomes in hospitalized women-a prospective study. Arch Womens Ment Health 22(1):85–91. https://doi.org/10.1007/s00737-018-0883-5

    Article  PubMed  Google Scholar 

  16. Yedid Sion M, Harlev A, Weintraub AY, Sergienko R, Sheiner E (2016) Is antenatal depression associated with adverse obstetric and perinatal outcomes? J Matern Fetal Neonatal Med 29(6):863–867. https://doi.org/10.3109/14767058.2015.1023708

    Article  PubMed  Google Scholar 

  17. Field T (2011) Prenatal depression effects on early development: a review. Infant Behav Dev 34(1):1–14. https://doi.org/10.1016/j.infbeh.2010.09.008

    Article  PubMed  Google Scholar 

  18. ACOG Committee Opinion No. 757 (2018) Screening for perinatal depression. American College of Obstetricians and Gynecologists. Obstet Gynecol 132:e208–12

    Article  Google Scholar 

  19. NICE (2014) National Institute for Health and Care Excellence. Antenatal and postnatal mental health: clinical management and service guidance. https://www.nice.org.uk/guidance/cg192

  20. RANZCOG (2015) The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Perinatal Anxiety and Depression (C-Obs 48)

  21. Siu AL, Force USPST, Bibbins-Domingo K, Grossman DC, Baumann LC, Davidson KW, Ebell M, Garcia FA, Gillman M, Herzstein J, Kemper AR, Krist AH, Kurth AE, Owens DK, Phillips WR, Phipps MG, Pignone MP (2016) Screening for depression in adults: US preventive services task force recommendation statement. JAMA 315(4):380–387. https://doi.org/10.1001/jama.2015.18392

    Article  CAS  PubMed  Google Scholar 

  22. Hidalgo Landa A, Szabo I, Le Brun L, Owen I, Fletcher G (2011) Evidence based scoping reviews. Electr J Inf Syst Eval 14:46–52

    Google Scholar 

  23. Arskey H, O’Malley L (2005) Scoping studies: towards a methodological framework. I J Soc Res Methodol 8(1):9–32

    Google Scholar 

  24. Daudt HM, van Mossel C, Scott SJ (2013) Enhancing the scoping study methodology: a large, inter-professional team’s experience with Arksey and O'Malley's framework. BMC Med Res Methodol 13:48. https://doi.org/10.1186/1471-2288-13-48

    Article  PubMed  PubMed Central  Google Scholar 

  25. Dagklis T, Tsakiridis I, Chouliara F, Mamopoulos A, Rousso D, Athanasiadis A, Papazisis G (2018) Antenatal depression among women hospitalized due to threatened preterm labor in a high-risk pregnancy unit in Greece. J Matern Fetal Neonatal Med 31(7):919–925. https://doi.org/10.1080/14767058.2017.1301926

    Article  PubMed  Google Scholar 

  26. Dame P, Cherubini K, Goveia P, Pena G, Galliano L, Facanha C, Nunes MA (2017) Depressive symptoms in women with gestational diabetes mellitus: the LINDA-Brazil study. J Diabetes Res 2017:7341893. https://doi.org/10.1155/2017/7341893

    Article  PubMed  PubMed Central  Google Scholar 

  27. Kharaghani R, Geranmaye M, Janani L, Hantooshzade S, Arbabi M, Rahmani Bilandi R, Bagheri F (2012) Preeclampsia and depression: a case–control study in Tehran. Arch Gynecol Obstet 286(1):249–253. https://doi.org/10.1007/s00404-012-2260-3

    Article  PubMed  Google Scholar 

  28. Qiu C, Sanchez SE, Lam N, Garcia P, Williams MA (2007) Associations of depression and depressive symptoms with preeclampsia: results from a Peruvian case-control study. BMC Womens Health 7:15. https://doi.org/10.1186/1472-6874-7-15

    Article  PubMed  PubMed Central  Google Scholar 

  29. Uguz F, Gezginc K, Yazici F (2011) Are major depression and generalized anxiety disorder associated with intrauterine growth restriction in pregnant women? A case–control study. Gen Hosp Psychiatry 33(6):640e647–649. https://doi.org/10.1016/j.genhosppsych.2011.05.007

    Article  Google Scholar 

  30. Tsakiridis I, Dagklis T, Zerva C, Mamopoulos A, Athanasiadis A, Papazisis G (2019) Depression in pregnant women hospitalized due to intrauterine growth restriction: prevalence and associated factors. Midwifery 70:71–75. https://doi.org/10.1016/j.midw.2018.12.008

    Article  PubMed  Google Scholar 

  31. Uguz F, Gezginc K, Korucu DG, Sayal B, Turgut K (2017) Are Major depression and generalized anxiety disorder associated with oligohydramnios in pregnant women? A case–control study. Perspect Psychiatr Care 53(4):275–279. https://doi.org/10.1111/ppc.12174

    Article  PubMed  Google Scholar 

  32. Bisson M, Series F, Giguere Y, Pamidi S, Kimoff J, Weisnagel SJ, Marc I (2014) Gestational diabetes mellitus and sleep-disordered breathing. Obstet Gynecol 123(3):634–641. https://doi.org/10.1097/AOG.0000000000000143

    Article  PubMed  Google Scholar 

  33. Ertel KA, Silveira M, Pekow P, Braun B, Manson JE, Solomon CG, Markenson G, Chasan-Taber L (2014) Prenatal depressive symptoms and abnormalities of glucose tolerance during pregnancy among Hispanic women. Arch Womens Ment Health 17(1):65–72. https://doi.org/10.1007/s00737-013-0379-2

    Article  PubMed  Google Scholar 

  34. Katon JG, Russo J, Gavin AR, Melville JL, Katon WJ (2011) Diabetes and depression in pregnancy: is there an association? J Womens Health (Larchmt) 20(7):983–989. https://doi.org/10.1089/jwh.2010.2662

    Article  Google Scholar 

  35. Ragland D, Payakachat N, Hays EB, Banken J, Dajani NK (2003) Ott RE (2010) Depression and diabetes: establishing the pharmacist’s role in detecting comorbidity in pregnant women. J Am Pharm Assoc 50(2):195–199. https://doi.org/10.1331/JAPhA.2010.09191

    Article  Google Scholar 

  36. Varela P, Spyropoulou AC, Kalogerakis Z, Vousoura E, Moraitou M, Zervas IM (2017) Association between gestational diabetes and perinatal depressive symptoms: evidence from a Greek cohort study. Prim Health Care Res Dev 18(5):441–447. https://doi.org/10.1017/S1463423617000317

    Article  PubMed  Google Scholar 

  37. Byrn M, Penckofer S (2015) The relationship between gestational diabetes and antenatal depression. J Obstet Gynecol Neonatal Nurs 44(2):246–255. https://doi.org/10.1111/1552-6909.12554

    Article  PubMed  Google Scholar 

  38. Huang T, Rifas-Shiman SL, Ertel KA, Rich-Edwards J, Kleinman K, Gillman MW, Oken E, James-Todd T (2015) Pregnancy hyperglycaemia and risk of prenatal and postpartum depressive symptoms. Paediatr Perinat Epidemiol 29(4):281–289. https://doi.org/10.1111/ppe.12199

    Article  PubMed  PubMed Central  Google Scholar 

  39. Keskin FE, Ozyazar M, Pala AS, Elmali AD, Yilmaz B, Uygunoglu U, Bozluolcay M, Tuten A, Bingol A, Hatipoglu E (2015) Evaluation of cognitive functions in gestational diabetes mellitus. Exp Clin Endocrinol Diabetes 123(4):246–251. https://doi.org/10.1055/s-0034-1395634

    Article  CAS  PubMed  Google Scholar 

  40. Natasha K, Hussain A, Khan AK (2015) Prevalence of depression among subjects with and without gestational diabetes mellitus in Bangladesh: a hospital based study. J Diabetes Metab Disord 14:64. https://doi.org/10.1186/s40200-015-0189-3

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Byatt N, Hicks-Courant K, Davidson A, Levesque R, Mick E, Allison J, Moore Simas TA (2014) Depression and anxiety among high-risk obstetric inpatients. Gen Hosp Psychiatry 36(6):644–649. https://doi.org/10.1016/j.genhosppsych.2014.07.011

    Article  PubMed  PubMed Central  Google Scholar 

  42. Murray L, Carothers AD (1990) The validation of the Edinburgh post-natal depression scale on a community sample. Br J Psychiatry 157:288–290

    Article  CAS  Google Scholar 

  43. Brouwers EP, van Baar AL, Pop VJ (2001) Does the Edinburgh postnatal depression scale measure anxiety? J Psychosom Res 51(5):659–663

    Article  CAS  Google Scholar 

  44. Gibson J, McKenzie-McHarg K, Shakespeare J, Price J, Gray R (2009) A systematic review of studies validating the Edinburgh Postnatal Depression Scale in antepartum and postpartum women. Acta Psychiatr Scand 119(5):350–364. https://doi.org/10.1111/j.1600-0447.2009.01363.x

    Article  CAS  PubMed  Google Scholar 

  45. Kroenke K, Spitzer RL, Williams JB (2001) The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 16(9):606–613

    Article  CAS  Google Scholar 

  46. Adouard F, Glangeaud-Freudenthal NM, Golse B (2005) Validation of the Edinburgh postnatal depression scale (EPDS) in a sample of women with high-risk pregnancies in France. Arch Womens Ment Health 8(2):89–95. https://doi.org/10.1007/s00737-005-0077-9

    Article  CAS  PubMed  Google Scholar 

  47. Thiagayson P, Krishnaswamy G, Lim ML, Sung SC, Haley CL, Fung DS, Allen JC Jr, Chen H (2013) Depression and anxiety in Singaporean high-risk pregnancies—prevalence and screening. Gen Hosp Psychiatry 35(2):112–116. https://doi.org/10.1016/j.genhosppsych.2012.11.006

    Article  PubMed  Google Scholar 

  48. Biaggi A, Conroy S, Pawlby S, Pariante CM (2016) Identifying the women at risk of antenatal anxiety and depression: a systematic review. J Affect Disord 191:62–77. https://doi.org/10.1016/j.jad.2015.11.014

    Article  PubMed  PubMed Central  Google Scholar 

  49. Melville JL, Gavin A, Guo Y, Fan MY, Katon WJ (2010) Depressive disorders during pregnancy: prevalence and risk factors in a large urban sample. Obstet Gynecol 116(5):1064–1070. https://doi.org/10.1097/AOG.0b013e3181f60b0a

    Article  PubMed  PubMed Central  Google Scholar 

  50. Vitale SG, La Rosa VL, Rapisarda AM, Lagana AS (2017) Psychology of infertility and assisted reproductive treatment: the Italian situation. J Psychosom Obstet Gynaecol 38(1):1–3. https://doi.org/10.1080/0167482X.2016.1244184

    Article  PubMed  Google Scholar 

  51. Gdanska P, Drozdowicz-Jastrzebska E, Grzechocinska B, Radziwon-Zaleska M, Wegrzyn P, Wielgos M (2017) Anxiety and depression in women undergoing infertility treatment. Ginekol Pol 88(2):109–112. https://doi.org/10.5603/GP.a2017.0019

    Article  PubMed  Google Scholar 

  52. Pope CJ, Sharma V, Sharma S, Mazmanian D (2015) A Systematic review of the association between psychiatric disturbances and endometriosis. J Obstet Gynaecol Can 37(11):1006–1015. https://doi.org/10.1016/S1701-2163(16)30050-0

    Article  PubMed  Google Scholar 

  53. Lagana AS, La Rosa VL, Rapisarda AMC, Valenti G, Sapia F, Chiofalo B, Rossetti D, Ban Frangez H, Vrtacnik Bokal E, Vitale SG (2017) Anxiety and depression in patients with endometriosis: impact and management challenges. Int J Womens Health 9:323–330. https://doi.org/10.2147/IJWH.S119729

    Article  PubMed  PubMed Central  Google Scholar 

  54. Zullo F, Spagnolo E, Saccone G, Acunzo M, Xodo S, Ceccaroni M, Berghella V (2017) Endometriosis and obstetrics complications: a systematic review and meta-analysis. Fertil Steril 108(4):667–672 e665. https://doi.org/10.1016/j.fertnstert.2017.07.019

    Article  PubMed  Google Scholar 

  55. Dennis CL, Falah-Hassani K, Shiri R (2017) Prevalence of antenatal and postnatal anxiety: systematic review and meta-analysis. Br J Psychiatry 210(5):315–323. https://doi.org/10.1192/bjp.bp.116.187179

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. 3rd Department of Obstetrics and Gynaecology, School of Medicine, Aristotle University of Thessaloniki, Thessaloníki, Greece

    Ioannis Tsakiridis & Themistoklis Dagklis

  2. Department of Clinical Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloníki, Greece

    Vasiliki Bousi, Chrysanthi Sardeli, Vasiliki Nikolopoulou & Georgios Papazisis

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  1. Ioannis Tsakiridis
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  2. Vasiliki Bousi
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  3. Themistoklis Dagklis
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  4. Chrysanthi Sardeli
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  5. Vasiliki Nikolopoulou
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  6. Georgios Papazisis
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Contributions

IT: project development, title and abstracts screening, data analysis, manuscript writing. VB: title and abstracts screening, data collection, data analysis, manuscript writing. TD: data analysis, manuscript drafting, CS: data collection, manuscript editing, VN: data collection, manuscript drafting, GP: project development, data analysis, manuscript writing and editing.

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Correspondence to Georgios Papazisis.

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Tsakiridis, I., Bousi, V., Dagklis, T. et al. Epidemiology of antenatal depression among women with high-risk pregnancies due to obstetric complications: a scoping review. Arch Gynecol Obstet 300, 849–859 (2019). https://doi.org/10.1007/s00404-019-05270-1

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