Low self-esteem is related to depression and anxiety during recovery from an ectopic pregnancy

Considering the increasing incidence of ectopic pregnancy and the negative effects of pregnancy loss on mental health, this study aimed to determine the status of mental health in women with ectopic pregnancy and examine its relationship with their self-esteem.

This was a cross-sectional study on 150 women (with a 100% response rate) hospitalized for ectopic pregnancy et al.-Zahra hospital in Tabriz, Iran, during 2018-2019, and recruited via convenience sampling. Data were collected using the General Health Questionnaire-28, which has four subscales (overall score range: 0 to 84; subscale score range: 0 to 21 with a lower score indicating a better mental state), and Rosenberg Self-Esteem Scale (score range: - 10 to + 10 with a higher score indicating higher self-esteem). To determine the association between self-esteem and mental health, independent t-tests, and multivariable logistic regression were used.

The response rate was 100%. The mean score (SD) of participants' mental health was 31.4 (8.5), and that of self-esteem was 4.5 (3.80). The percentage of participants who were considered as having mental distress (i.e., overall GHQ-28 score ≥ 24) was 76%. Among the subscales of mental health, social dysfunction was the most prevalent (observed in 100% of the participants), followed by somatic symptoms (79.3%). Lower self-esteem was significantly associated with overall mental distress (odds ratio (OR): 0.74; 95% confidence interval (95% CI): 0.64-0.87; P < 0.001), depression (OR: 0.70; 95% CI: 0.60-0.80; P < 0.001) and anxiety/insomnia (OR: 0.76; 95% CI: 0.66-0.87; P < 0.001).

Mental distress was common among women with ectopic pregnancy. This study is the first to examine the relationship between self-esteem and mental health among women with ectopic pregnancy and highlights the important role of self-esteem in mental wellbeing among those women.