title: Depression and anxiety in early pregnancy and risk for preeclampsia.
abstract: 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 outpatient maternity clinics in the Helsinki metropolitan area, depression was assessed by a Finnish modification of the short form of the Beck Depression Inventory and anxiety by one established question. Preeclampsia was defined as elevated blood pressure (BP) (more than 140/100 mmHg) and proteinuria (0.3 g during 24 hours or more). Age, smoking, alcohol consumption, marital status, socioeconomic status, and bacterial vaginosis were analyzed as potentially confounding factors in a multiple logistic regression analysis.
  
  
  RESULTS
  Six hundred twenty-three consecutive nulliparous women with singleton pregnancies were studied at ten to 17 (median 12) weeks' gestation and at delivery. Of them, 28 (4.5%) women developed preeclampsia. Depression (mean Beck score 4.5, range 3-17) was observed in 185 (30%), women and anxiety was observed in 99 (16%) in early pregnancy. In multivariate analysis, after adjustment for potentially confounding factors, depression was associated 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 depression was associated with increased risk (OR 5.3; 95% CI 1.8, 15.0) for preeclampsia.
  
  
  CONCLUSIONS
  Depression and anxiety in early pregnancy are associated with risk for subsequent preeclampsia, a risk further increased by bacterial vaginosis.
authors.affiliation: Department of Obstetrics and Gynecology, University Central Hospital of Helsinki, Helsinki, Finland. tapio.kurki@huch.fi
authors.forename: T
authors.initials: T
authors.lastname: Kurki
authors.forename: V
authors.initials: V
authors.lastname: Hiilesmaa
authors.forename: R
authors.initials: R
authors.lastname: Raitasalo
authors.forename: H
authors.initials: H
authors.lastname: Mattila
authors.forename: O
authors.initials: O
authors.lastname: Ylikorkala
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000150:complications*; D003863:Depression / Q000150:complications*; D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000453:epidemiology / Q000209:etiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology*; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D011446:Prospective Studies; D012307:Risk Factors