GAD-7 and PHQ-9 measurement of perinatal anxiety and depression in women with hypertensive disorders of pregnancy in Yaounde, Cameroon

Authors

  • Felix Essiben Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences (FMBS), the University of Yaoundé , Cameroon
  • Esther Meka Ngo Um Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences (FMBS), the University of Yaoundé , Cameroon
  • Samuel Ojong Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences (FMBS), the University of Yaoundé , Cameroon
  • Felix Gimnwi Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences (FMBS), the University of Yaoundé , Cameroon
  • Kamga Olen Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences (FMBS), the University of Yaoundé , Cameroon
  • Philip Njotang Nana Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences (FMBS), the University of Yaoundé , Cameroon

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20182312

Keywords:

Anxiety, Depression, Hypertension, Perinatal, Pregnancy, Preeclampsia

Abstract

Background: The aim of the study was to determine the prevalence of perinatal anxiety and depression in women with hypertensive diseases during pregnancy in Yaounde.

Methods: Authors carried out a cross-sectional descriptive study over nine months from October 2015 to May 2016, amongst pregnant women with hypertensive pregnancy disorders followed up in three tertiary care centers in Yaounde. Authors collected information from the medical files of selected patients by using a pre-tested and validated questionnaire in the perinatal period. We classified blood pressure values as per the JNC 7 recommendations. Anxiety and mental depression were evaluated for using the Generalized Anxiety Disorder 7-item and the Patient Health Questionnaires-9 respectively. Data analysis was done using CSPro version 6.2 and SPSS version 20.0 software.

Results: Authors included 202 patients during the study period. The mean age stood at 25.9± 6.4years (extremes 13-43years). Amongst these, 47.5% were single while 97.5% (197/202) had received at least primary education. Students represented 45.5% (92/202) of women while 102 (50.5%) of them had some form of employment in the public, private or informal sectors. Severe preeclampsia was the most prevalent hypertensive disorder in these women, with 69 (34.2%) developing eclampsia. We found that 79% (161/202) of these patients suffered from anxiety, 67.3% (136/202) were depressive while 61.3% (124/202) had both anxiety and depression.

Conclusions: The prevalence of perinatal anxiety and depression in women with hypertensive pregnancy disorders is high. Associated factors must be looked out in order to prevent these situations.

References

Lumley J. Defining the problem: The epidemiology of preterm birth. BJOG. 2003;110(Suppl 20):3-7.

American Psychiatric Association: Diagnostic and Statistical Manual for Psychiatric Disorders, 4th ed, text revision. Washington DC, American Psychiatric Association, 2000.

Cunningham F, Leveno K, Bloom S, Hauth J, Rouse D, Spong C. 23rd ed. New York: The Mc Graw Hill Medical publishing; 2010. Williams Obstetrics; p. 646,706-728,1176-1180.

Meltzer-Brody S. New insights into perinatal depression: pathogenesis and treatment. Dialogues Clin Neurosci. 2011;13(1):89-100.

Kurki T, Hiilesmaa V, Raitasalo R, Mattila H, Ylikorkala O. Depression and anxiety in early pregnancy and risk for preeclampsia. Obstet Gynecol. 2000;95(4):487-90.

Chung T, Lau TK, Yip A, Chiu H, Lee D. Ante partum depressive symptomatology is associated with adverse obstetric and neonatal outcomes. Psychosom Med. 2001;63:830-34.

American College of Obstetricians and Gynecologists Committee on Health Care for Undeserved Women. ACOG Committee Opinion No. 343. Psychosocial risk factors: perinatal screening and intervention. Obstet Gynecol. 2006;108:469-77.

Royal College of Obstetricians and Gynaecologists. Antenatal care: Routine care for the healthy pregnant woman. London: RCOG Press; 2008.

Ladouceur R, Marchand A, Boisvert J M. Anxiety Disorders: Cognitive and Behavioral Approach. Masson, Paris, 1999 [french].

Thiagayson P, Krishnaswamy G, Lim ML, Sung SC, Haley CL, Fung DS, et al. Depression and anxiety in Singaporean high-risk pregnancies-prevalence and screening. Gen Hosp Psychiatry. 2013;35:112-6.

Azizi M, Lamyian M, Faghihzadeh S, Nematollahzadeh M. Effectiveness of counseling on anxiety after traumatic childbirth in nulliparous women: A randomized single blind randomized clinical. J Med Sci Kermanshah. 2010;13:219-27.

Ross LE, Dennis CL. The prevalence of postpartum depression amongst women with substance use, an abuse history, or chronic illness: a systematic review. J Womens Health (Larchmt). 2009;18(4):475-86.

Munk-Olsen T, Laursen TM, Pedersen CB, Mors O, Mortensen PB. New parents and mental disorders: a population-based register study. JAMA. 2006;296(21):2582-9.

Lindahl V, Pearson JL, Colpe L. Prevalence of suicidality during pregnancy and the postpartum. Arch Womens Ment Health. 2005;8(2):77-87.

Rahman A, Iqbal Z, Bunn J, Lovel H, Harrington R. Impact of maternal depression on infant nutritional status and illness: a cohort study. Arch Gen Psychiatry. 2004;61:946-52.

Campbell SB, Brownell CA, Hungerford A, Spieker SI, Mohan R, Blessing JS. The course of maternal depressive symptoms and maternal sensitivity as predictors of attachment security at 36 months. Dev Psychopathol. 2004;16(2):231-52.

American College of Obstetricians and Gynecologists. Committee on Obstetric Practice. Committee opinion no. 453: Screening for depression during and after pregnancy. Obstet Gynecol. 2010;115:394-5.

Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Am J Obstet Gynecol. 2000;183(1):S1-S22.

Motaze VN. Clinical varieties of hypertensive diseases in pregnancy in the Yaoundé Gynecologic, Obstetric and Pediatric Hospital. MD thesis (unpublished), FMBS UY1, Yaoundé; 2007.

Borgan K. Perinatal depression and anxiety: beyond psychopharmacology. Psychiatr Clin North Am. 2013;36(1):183-8.

Rubertsson C, Hellström J, Cross M, Sydsjö G. Anxiety in early pregnancy: Prevalence and contributing factors. Arch Womens Ment Health. 2014;17(3):221-8.

Kharaghani R, Geranmaye M, Janani L, Hantooshzade S, Arbabi M, Rahmani Bilandi R, et al. Preeclampsia and depression: A case-control study in Tehran. Arch Gynecol Obstet. 2014;286(1):249-53.

Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092-7.

Spitzer RL, Williams JB, Kroenke K, Hornyak R, McMurray J. Validity and utility of the PRIME-MD patient health questionnaire in assessment of 3000 obstetric-gynecologic patients: the PRIME-MD Patient Health Questionnaire Obstetrics-Gynecology Study. Am J Obstet Gynecol. 2000;183(3):759-69.

Adouard F, Glangeaud-Freudenthal NMC, Golse. Validation of the EPDS in a sample of women with high-risk pregnancies in France. Arch Womens Ment Health. 2005;8(2):89-95.

Gourounti V, Karapnou V, Karpathiotaki N, Vaslamatzis G. Anxiety and depression of high risk pregnant women hospitalized in two public hospital settings in Greece. Int Arch Med. 2015;8(25):33-37.

Brandon AR, Trivedi MH, Hynan LS, Miltenberger PD, Labat DB, Rifkin JB, et al. Prenatal depression in women hospitalized for obstetric risk. J Clin Psychiatry. 2008; 69(4):635-43.

Hu HQ, Zhang J, Zhao W, Tian T, Huang AQ, Wang LL. The occurrence and determinants of anxiety and depression symptoms in women of six counties/ districts in China during pregnancy. Chinese J Prev Med. 2017;51(1):47-52.

Bener A. Psychological distress among postpartum mothers of preterm infants and associated factors: a neglected public health problem. Rev Bras Psiquiatr. 2013;35(3):231-6.

Quelopana AM, Champion JD, Reyes-Rubilar T. Factors associated with postpartum depression in Chilean women. Health Care Women Int. 2011;32(10):939-49.

Gla´ucia Rosana Guerra Benute, Roseli Mieko Yamamoto Nomura, Juliana Siracuza Reis,I Rene´rio Fraguas Junior, Mara Cristina Souza de Lucia, Marcelo Zugaib. Depression during pregnancy in women with a medical disorder: risk factors and perinatal outcomes. Clinics. 2010;65(11):1127-31.

Hantsoo L, Epperson CN. Anxiety Disorders Among Women: A Female Lifespan Approach. Focus (Am Psychiatr Publ). 2017 Spring;15(2):162-72.

Parsa P, Saeedzadeh N, Masoumi SZ, Roshanaei G. The Effectiveness of counseling in reducing anxiety among nulliparous pregnant women. J Family Reprod Health. 2016;10(4):198-205.

Abedian Z, Soltani N, Mokhber N, Esmaily H. Depression and anxiety in pregnancy and postpartum in women with mild and severe preeclampsia. Iran J Nurs Midwifery Res. 2015;20(4):454-9.

Ross LE, McLean LM, Psych C. Anxiety disorders during pregnancy and the postpartum period: A systematic review. J Clin Psychiatry. 2006;67(8):1285-98.

Ferreira CR, Orsini MC, Vieira CR, do Amarante Paffaro AM, Silva RR. Prevalence of anxiety symptoms and depression in the third gestational trimester. Arch Gynecol Obstet. 2015;291(5):999-1003.

Mannikam L, Burns J K. Antenatal depression and its risk factors: An urban prevalence study in KwaZulu-Natal. S Afr Med J 2012; 102(12):940-4.

Hoedjes M, Berks D, Vogel I, Franx A, Bangma M, Darlington AS, et al. Postpartum depression after mild and severe preeclampsia. J Womens Health (Larchmt). 2011;20:1535-42.

Alipour Z, Lamyian M, Hajizadeh E. Anxiety and fear of childbirth as predictors of postnatal depression in nulliparous women. Women Birth. 2012;25(3):e37-43.

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Published

2018-05-26

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Original Research Articles