Psychological Distress and Maternal Outcomes in Women With Pre-eclampsia: A Retrospective Case-Control Study

Pre-eclampsia (PE) is a significant pregnancy complication associated with adverse maternal and neonatal outcomes. This study aimed to explore the relationship between anxiety and depression symptoms and PE, as well as maternal and neonatal outcomes.

This retrospective case-control cohort study included 2184 pregnant women enrolled in the Pregnant Women's Mental Health Registry between 2022 and September 2024, among whom PE was diagnosed. Based on the inclusion criteria, 196 women with PE were selected. A control group of 366 women without PE, matched for age and number of pregnancies, was included. Statistical analyses were performed using Chi-square, Mann-Whitney, and Kruskal-Wallis tests.

Women with PE exhibited significantly higher frequencies of depressive symptoms (26.5% vs. 16.7%, p = 0.004), anxiety symptoms (34.2% vs. 16.7%, p < 0.001), and psychological distress (46.9% vs. 26%, p < 0.001) compared to women without PE. Additionally, women with PE experienced more frequent adverse maternal outcomes, including shorter pregnancy duration, higher rates of emergency cesarean sections, bleeding, and postpartum infections (p < 0.001). Similarly, neonatal outcomes were worse in the PE group, with higher rates of NICU admission, low birth weight, birth trauma, and hospitalization within 6 weeks post-birth (including measurements of height and head circumference) (p < 0.001). However, anxiety and depression scores did not significantly affect maternal and neonatal outcomes, except in women with PE whose infants were hospitalized within 6 weeks of birth, where higher anxiety scores and psychological distress were observed.

The increased prevalence of anxiety and depression symptoms in women with PE, along with their association with adverse maternal and neonatal outcomes, underscores the need to address psychological factors in the management of PE. Incorporating psychological support alongside medical care is recommended for obstetricians and healthcare providers.