Psychological Factors affecting Outcome of Pregnancy

Background and Objective: Studies suggest that antenatal depressive and anxiety disorders are associated with more negative events during pregnancy and delivery. This study was conducted to observe the outcome of pregnancy in women who had psychological distress (anxiety or depression) during pregnancy visiting the antenatal clinic. Materials and Methods: This is a prospective, hospital-based study. Pregnant women visiting the antenatal clinic, who gave consent to participate in the study, were administered the general health questionnaire 12, to screen for psychological distress in the first, second or third trimesters. Women scoring less than three were considered as ones without psychological distress and were again screened in the next trimester. Women scoring three and above in any trimester were deemed to have significant psychological distress and were further administered the Hamilton anxiety rating scale (HAM-A) and the Hamilton depression rating scale (HAM-D). All women were followed up to know the outcome of their pregnancy. The gestational period was assessed based on patient's last menstrual period. The results were analysed using appropriate statistical measures. Results: Out of 180 pregnant women, 21% had psychological distress. Women with antenatal psychological distress had significantly more preterm delivery (13.2%), low-birth-weight baby (31.6%) and underwent caesarean section due to delivery complications (42.1%). Almost similar findings were seen in women with antenatal psychological distress in the third trimester. Mild-to-moderate level of antenatal anxiety (50%) on HAM-A was statistically significantly associated with preterm delivery. Conclusion: Antenatal psychological distress, especially during the third trimester, had more negative pregnancy outcomes, like preterm delivery, low-birth-weight baby and undergoing caesarean section due to delivery complications. Mild-to-moderate level of anxiety was found to be statistically significantly associated with preterm delivery.