Quality of life, depression and anxiety among pregnant women with previous adverse pregnancy outcomes
Keywords:
Quality of life, Depression, Anxiety, Pregnancy, Reproductive historyAbstract
CONTEXT AND OBJECTIVE: Previous adverse pregnancy outcomes (recurrent spontaneous abortion, fetal death, preterm birth or early neonatal death) can affect the quality of life of pregnant women. The objective of this study was to compare the quality of life and the prevalence of symptoms of anxiety and depression among pregnant women with and without these antecedents. DESIGN AND SETTING: An analytical cross-sectional study was performed in four settings (two high-risk and two low-risk prenatal clinics) in the city of Campinas, São Paulo, Brazil. METHODS: A total of 240 women were interviewed by a single investigator between the 18th and 24th weeks of gestation: 120 women with prior adverse pregnancy outcomes (group 1) and 120 women with no such history (group 2), matched according to their numbers of living children. Sociodemographic variables were collected and two questionnaires were used: the Short Form-36 quality-of-life questionnaire and the Depression and Anxiety Scale. RESULTS: The women in group 1 had lower scores in all the items on the quality-of-life questionnaire. Depression and anxiety were more frequent in group 1 (P < 0.0001). An inverse correlation was found between the Short Form-36 domains and anxiety and depression. CONCLUSIONS: Women with histories of recurrent spontaneous abortion, fetal death, preterm birth or early neonatal death seem to have poorer quality of life and more symptoms of anxiety and depression during their subsequent pregnancy, compared with those without such antecedents.
Downloads
References
Armstrong DS. Impact of prior perinatal loss on subsequent pregnancies. J Obstet Gynecol Neonatal Nurs. 2004;33(6):765-73.
Franche RL, Mikail SF. The impact of perinatal loss on adjustment to subsequent pregnancy. Soc Sci Med. 1999;48(11):1613-23.
Horowitz M. Stress response syndromes. Character style and dynamic psychotherapy. Arch Gen Psychiatry. 1974;31(6):768-81.
Mason S, Rowlands A. Post-traumatic stress disorder. J Accid Emerg Med. 1997;14(6):387-91.
Adeyemi A, Mosaku K, Ajenifuja O, Fatoye F, Makinde N, Ola B. Depressive symptoms in a sample of women following perinatal loss. J Natl Med Assoc. 2008;100(12):1463-8.
Armstrong DS. Emotional distress and prenatal attachment in pregnancy after perinatal loss. J Nurs Scholarsh. 2002;34(4):339-45.
Cabrol D, Landesman R, Muller J, Uzan M, Sureau C, Saxena BB. Treatment of polyhydra- mnios with prostaglandin synthetase inhibitor (indomethacin). Am J Obstet Gynecol. 1987;157(2):422-6.
Leboeuf-Yde C, Kyvik KO, Bruun NH. Low back pain and lifestyle. Part II--Obesity. Informa- tion from a population-based sample of 29,424 twin subjects. Spine (Phila Pa 1976). 1999;24(8):779-83; discussion 783-4.
McDonnell NJ, Paech MJ. The management of a super morbidly obese parturient delivering twins by caesarean section. Anaesth Intensive Care. 2007;35(6):979-83.
Cunningham FG, Gant NF, Leveno KJ, Gilstrap LC, Hauth JC, Wenstrom KD. Abortion. In: Cunningham FG, Gant NF, Leveno KJ, Gilstrap LC, Hauth JC, Wenstrom KD, editors. Williams obstetrics. New York: McGraw-Hill; 2001. p. 855-82.
World Health Organization. Department of Reproductive Health and Research. Reproductive health indicators: guidelines for their generation, interpretation and analysis for global mo- nitoring. Geneva: World Health Organization; 1998.
Valdez RB, Ware JE Jr, Manning WG, et al. Prepaid group practice effects on the utilization of medical services and health outcomes for children: results from a controlled trial. Pediatrics. 1989;83(2):168-80.
Ciconelli RM, Ferraz MB, Santos W, Meinão I, Quaresma MR. Tradução para a língua por- tuguesa e validação do questionário genérico de avaliação de qualidade de vida SF-36 (Brasil SF-36) [Brazilian-Portuguese version of the SF-36. A reliable and valid quality of life outcome measure]. Rev Bras Reumatol. 1999;39(3):143-50.
Favarato MECS, Aldrighi JM. A mulher coronariopata no climatério após a menopausa: impli- cações na qualidade de vida [The post menopausal climacteric woman with coronary artery disease: implications to quality of life]. Rev Assoc Med Bras. 2001;47(4):339-45.
Neto JF, Ferraz MB, Cendoroglo M, Draibe S, Yu L, Sesso R. Quality of life at the initiation of maintenance dialysis treatment--a comparison between the SF-36 and the KDQ question- naires. Qual Life Res. 2000;9(1):101-7.
Marques AA. Qualidade de vida de mulheres com endometriose através do SF-36 [disser- tation]. Campinas: Faculdade de Ciências Médicas da Universidade Estadual de Campinas; 2002.
Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361-70.
Smith EM, Gomm SA, Dickens CM. Assessing the independent contribution to quality of life from anxiety and depression in patients with advanced cancer. Palliat Med. 2003;17(6): 509-13.
Snaith RP. The Hospital Anxiety And Depression Scale. Health Qual Life Outcomes. 2003;1:29.
Botega NJ, Bio MR, Zomignani MA, Garcia Junior C, Pereira WAB. Transtornos do humor em enfermaria de clínica médica e validação de escala de medida (HAD) de ansiedade e depressão [Mood disorders among medical in-patients: a validation study of the hospital anxiety and depression scale (HAD)]. Rev Saude Publica = J Public Health. 1995;29(5): 355-63.
Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Concep- tual framework and item selection. Med Care. 1992;30(6):473-83.
Ware J Jr, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34(3):220-33.
Mckee MD, Cunningham M, Jankowski KR, Zayas L. Health-related functional status in preg- nancy: relationship to depression and social support in a multi-ethnic population. Obstet Gynecol. 2001;97(6):988-93.
Jomeen J, Martin CR. The factor structure of the SF-36 in early pregnancy. J Psychosom Res. 2005;59(3):131-8.
Kelly RH, Russo J, Katon W. Somatic complaints among pregnant women cared for in obs- tetrics: normal pregnancy or depressive and anxiety symptom amplification revisited? Gen Hosp Psychiatry. 2001;23(3):107-13.
Côte-Arsenault D, Mahlangu N. Impact of perinatal loss on the subsequent pregnancy and self: women’s experiences. J Obstet Gynecol Neonatal Nurs. 1999;28(3):274-82.
Vance JC, Najman JM, Thearle MJ, Embelton G, Foster WJ, Boyle FM. Psychological changes in parents eight months after the loss of an infant from stillbirth, neonatal death, or sudden infant death syndrome--a longitudinal study. Pediatrics. 1995;96(5 Pt 1):933-8.
Armstrong D, Hutti M. Pregnancy after perinatal loss: the relationship between anxiety and prenatal attachment. J Obstet Gynecol Neonatal Nurs. 1998;27(2):183-9.
Lindgren K. Relationships among maternal-fetal attachment, prenatal depression, and heal- th practices in pregnancy. Res Nurs Health. 2001;24(3):203-17.
Bhagwanani SG, Seagraves K, Dierker LJ, Lax M. Relationship between prenatal anxie- ty and perinatal outcome in nulliparous women: a prospective study. J Natl Med Assoc. 1997;89(2):93-8.
Teixeira JM, Fisk NM, Glover V. Association between maternal anxiety in pregnancy and increased uterine artery resistance index: cohort based study. BMJ. 1999;318(7177): 153-7.
Hobel CJ, Ross MG, Bemis RL, et al. The West Los Angeles Preterm Birth Prevention Project I. Program impact on high-risk women. Am J Obstet Gynecol. 1994;170(1 Pt 1):54-62.
Dejin-Karlsson E, Hanson BS, Ostergren PO, Lindgren A, Sjöberg NO, Marsal K. Association of a lack of psychosocial resources and the risk of giving birth to small for gestational age infants: a stress hypothesis. BJOG. 2000;107(1):89-100.
