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Cited by 104Maternal Mental Health During Pregnancy and PostpartumMaternal and Neonatal HealthcareMaternal and Perinatal Health Interventions

Depression and anxiety among high-risk obstetric inpatients

Open access
Byatt, Nancy, Hicks-Courant, Katherine, Davidson, Autumn, Levesque, Ruth, Mick, Eric, Allison, Jeroan, Moore Simas, Tiffany A.·2014·General Hospital Psychiatry
DOI 10.1016/j.genhosppsych.2014.07.011PMC PMC4399814
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Abstract

Objective To assess the following among women hospitalized antenatally due to high-risk pregnancies: (1) rates of depression symptoms and anxiety symptoms, (2) changes in depression symptoms and anxiety symptoms and, (3) rates of mental health treatment.Methods Sixty-two participants hospitalized for high-risk obstetrical complications completed the Edinburgh Postnatal Depression Scale (EPDS), Generalized Anxiety Disorder 7-item scale (GAD-7) and Short-Form 12 weekly until delivery or discharge, and once postpartum.Results Average length of total hospital stay was 8.3 ± 7.6 days for women who completed an initial admission survey (n = 62) and 16.3 ± 8.9 (n = 34), 25.4 ± 10.2 (n = 17) and 35 ± 10.9 days (n = 9) for those who completed 2, 3 and 4 surveys, respectively. EPDS was ≥ 10 in 27% (n=17) and GAD-7 was ≥ 10 in 13% (n = 8) of participants at initial survey. Mean anxiety (4.2 ± 6.5 vs. 5.2 ± 5.1, p = .011) and depression (4.4 ± 5.6 vs. 6.9 ± 4.8, p = .011) scores were lower postpartum compared to initial survey. Past mental health diagnosis predicted depression symptoms [odds ratio (OR) = 4.54; 95% confidence interval (CI) 1.91-7.17] and anxiety symptoms (OR = 5.95; 95% CI 3.04-8.86) at initial survey; however, 21% (n = 10) with no diagnostic history had EPDS ≥ 10. Five percent (n = 3) received mental health treatment during pregnancy.Conclusion Hospitalized high-risk obstetrical patients may commonly experience depression symptoms and/or anxiety symptoms and not receive treatment. A history of mental health treatment or diagnosis was associated with depression symptoms or anxiety symptoms in pregnancy. Of women with an EPDS ≥ 10, > 50% did not report a past mental health diagnosis.

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  • This study is the largest to date demonstrating an increased risk of depression symptoms postpartum compared to the general obstetric population.

    “our study (n = 4161) is the largest to date demonstrating an increased risk of depression symptoms postpartum compared to the general obstetric population.”

    From Factors associated with postpartum depression symptoms following antepartum hospitalization (2026) · cites this paper as [49]

    The Discussion reports higher depression-symptom rates in high-risk obstetric inpatients than previously reported in nonhospitalized pregnant women. It does not establish increased risk postpartum relative to the general obstetric population; the Results instead report lower scores postpartum than at admission. The n = 4161 and largest-to-date description refer to the citing authors’ own study, not this source. (LLM, conf=0.82)

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  • The high underreporting of pregnant women with prenatal depression and anxiety disorders is consistent with findings from other studies.

    “The high underreporting of pregnant women with prenatal depression and anxiety disorders is consistent with findings from other studies.”

    From Acceptance, experiences, and needs of hospitalized pregnant women toward an electronic mindfulness-based intervention: A pilot mixed-methods study (2022) · cites this paper as [62]

    The Results and Discussion report that many high-risk obstetric inpatients screened positive for depression or anxiety symptoms despite lacking a prior mental health diagnosis or assessment. But the Discussion says the study did not establish whether participants had depressive or anxiety disorders, and it did not measure underreporting by pregnant women. Its comparison with earlier studies concerns symptom rates, not underreporting. (LLM, conf=0.86)

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  • Byatt et al. reported that despite the high prevalence of depression (26.9%) and anxiety symptoms (12.6%), high-risk inpatient pregnant women rarely receive psychological screening and/or treatment (5%).

    “Byatt et al. reported that despite the high prevalence of depression (26.9%) and anxiety symptoms (12.6%), high-risk inpatient pregnant women rarely receive psychological screening and/ or treatment (5%) (62).”

    From Acceptance, experiences, and needs of hospitalized pregnant women toward an electronic mindfulness-based intervention: A pilot mixed-methods study (2022) · cites this paper as [62]

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Authors
Byatt, N., Hicks-Courant, K., Davidson, A., Levesque, R., Mick, E., Allison, J., & Moore Simas, T. A.
Affiliations
  • University of Massachusetts Chan Medical School (US)
  • University of Chicago Medical Center (US)
Corresponding author
Byatt, Nancy
ORCID
Venue
General Hospital Psychiatry
Publisher
Elsevier BV
Published
2014-11
Volume
36
Issue
6
Pages
644-649
ISSN
0163-8343 (ISSN-L)
DOI
10.1016/j.genhosppsych.2014.07.011
PMC
PMC4399814
OpenAlex
W2089442606
Cited by
104
References
43
Citations by year
2026: 6 · 2025: 6 · 2024: 5 · 2023: 10 · 2022: 16 · 2021: 11 · 2020: 10 · 2019: 12 · 2018: 11 · 2017: 4 · 2016: 7 · 2015: 6
FWCI
5.61
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • General Hospital Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Center for Research Resources
  • National Center for Advancing Translational Sciences, National Institutes of Health (NIH) (KL2TR000160)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Keywords
antenatal depression, prenatal anxiety, high-risk pregnancy, postpartum mental health, Edinburgh Postnatal Depression Scale, GAD-7, psychotherapy, pregnancy complications
MeSH terms
Adult, Anxiety, Depression, Female, Hospitalization, Humans, Inpatients, Length of Stay, Pregnancy, Pregnancy Complications, Prospective Studies, Surveys and Questionnaires, Cohort Studies, Pregnancy, High-Risk, Postpartum Period, Young Adult, Peripartum Period

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