Dysphoria among high-risk pregnant hospitalized women on bed rest: a longitudinal study.
BACKGROUND
While approximately 700,000 women experience pregnancy complications and are treated with bed rest in the hospital each year, little is known about negative affect in these women.


OBJECTIVE
The study purpose was to describe dysphoria, a composite of symptoms of negative affect across the antepartum and postpartum and to identify the relationship between dysphoria and the length of pre-admission home bed rest, hospital bed rest, and maternal and fetal/neonatal indices of risk.


METHODS
The convenience sample for this longitudinal repeated measures study consisted of 63 high-risk pregnant women admitted on antepartum bed rest to one of three university-affiliated hospitals. Women were included if they were diagnosed with (a) preterm labor, (b) premature rupture of membranes, (c) incompetent cervix, (d) placenta previa, (e) placental abruption or multiple gestation, and (f) did not have a psychiatric disorder. The Multiple Affect Adjective Checklist-Revised (MAACL-R) was used to assess dysphoria. Obstetric risk status was assessed by both the Hobel and Creasy Risk Assessment tools.


RESULTS
Dysphoria was highest upon hospital admission and decreased significantly across time (F (5) = 23.58, p <.001). Positive Affect-Sensation Seeking significantly increased across time (F (5) = 53.16, p <.001). Dysphoria scores were significantly greater for those with highest Hobel obstetric risk scores (F (1, 60) = 4.53, p =.037). Antepartum dysphoria was not correlated with gestational age upon hospital admission, length of bed rest, or Creasy risk status. However, gestational age at birth was significantly correlated with postpartum dysphoria.


CONCLUSIONS
The stimulus for antepartum dysphoria is unclear. However, postpartum dysphoria appears to be related to indicators of the infant's state of health at birth.
Maloni
Judith A
JA
Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio 44106-4904, USA.
Kane
Janet H
JH
Suen
Lee-Jen
LJ
Wang
Kokung K
KK
D000037:Abruptio Placentae / Q000523:psychology; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology*; D001510:Bed Rest / Q000009:adverse effects / Q000523:psychology*; D003863:Depression / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000523:psychology; D005865:Gestational Age; D006760:Hospitalization; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008137:Longitudinal Studies; D007752:Obstetric Labor, Premature / Q000523:psychology; D010923:Placenta Previa / Q000523:psychology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000517:prevention & control / Q000523:psychology*; D018566:Pregnancy, High-Risk / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D013997:Time Factors; D002581:Uterine Cervical Incompetence / Q000523:psychology