Psychological distress in pregnant women undergoing prolonged hospitalization: A prospective observational study

To evaluate the prevalence and severity of depressive and anxiety symptoms in pregnant women undergoing prolonged antepartum hospitalization and to explore clinical, obstetric, and psychosocial factors associated with psychological distress.

This prospective observational study included 118 pregnant women undergoing prolonged antepartum hospitalization (>7 consecutive days) at the Obstetrics and Gynecology Unit of Umberto I Hospital, Kore University of Enna, Italy. Psychological assessment was performed once after the seventh day of hospitalization using the validated Italian versions of the Edinburgh Postnatal Depression Scale (EPDS) and Generalized Anxiety Disorder-7 (GAD-7), followed by an individual clinical psychological interview. Associations between psychological outcomes and selected sociodemographic, obstetric, and psychosocial variables were explored.

Depressive and anxiety symptoms were frequent in the study population. An EPDS score ≥ 10 was observed in 69.5% of participants, while 60.2% scored ≥ 12. Overall, 87.3% of women scored ≥ 10 on the GAD-7. Women reporting recent stressful life events had significantly higher EPDS and GAD-7 scores. In exploratory multivariable analyses, recent stressful life events were associated with higher depressive and anxiety symptom burden, while family psychiatric history was associated with higher depressive symptom scores.

Pregnant women undergoing prolonged antepartum hospitalization showed a high burden of depressive and anxiety symptoms. Psychosocial factors, particularly recent stressful life events, were associated with greater symptom severity. These findings support the potential value of systematic mental health screening and timely psychological assessment in hospitalized obstetric populations. Further controlled studies are needed to clarify the independent contribution of hospitalization to psychological distress.