title: Depression and anxiety among high-risk obstetric inpatients.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA, 01655, USA; Department of Obstetrics and Gynecology, University of Massachusetts Medical School, Worcester, MA, USA. Electronic address: nancy.byatt@umassmemorial.org.
authors.forename: Nancy
authors.initials: N
authors.lastname: Byatt
authors.affiliation: Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA, 01655, USA; Department of Obstetrics and Gynecology, University of Massachusetts Medical School, Worcester, MA, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Hicks-Courant
authors.affiliation: University of Chicago Medical Center, Chicago, IL, USA.
authors.forename: Autumn
authors.initials: A
authors.lastname: Davidson
authors.affiliation: Department of Obstetrics and Gynecology, University of Massachusetts Medical School, Worcester, MA, USA.
authors.forename: Ruth
authors.initials: R
authors.lastname: Levesque
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Mick
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA.
authors.forename: Jeroan
authors.initials: J
authors.lastname: Allison
authors.affiliation: Department of Obstetrics and Gynecology, University of Massachusetts Medical School, Worcester, MA, USA.
authors.forename: Tiffany A
authors.initials: TA
authors.lastname: Moore Simas
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology* / Q000628:therapy; D015331:Cohort Studies; D003863:Depression / Q000523:psychology* / Q000628:therapy; D005260:Female; D006760:Hospitalization; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D007902:Length of Stay; D058725:Peripartum Period / Q000523:psychology*; D049590:Postpartum Period / Q000523:psychology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology* / Q000628:therapy; D018566:Pregnancy, High-Risk / Q000523:psychology*; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Anxiety; Depression; High-risk; Hospitalization; Pregnancy