Determining psychological distress during pregnancy and its association with the development of a hypertensive disorder

Objective: To explore the association of psychological distress, including stress, depression, and anxiety, with the development of a hypertensive disorder during pregnancy. Design: A secondary data analysis using a 1:3 case control study; cases (n = 29 with a hypertensive disorder) and controls (n = 87 without hypertension) frequency matched on age and parity. Participants: Women in the study were older than 14 years of age, Medicaid eligible, with at least one risk factor for preterm birth, and without a current diagnosis of mental illness. Methods: Hypertensive disorder status was verified through medical record report. Components of psychological distress were measured with valid instruments. Measures of psychological distress level, including CESD-R-10, PSS-4, and GAD-7, were compared between women with a hypertensive disorder and normotensive women were made in both early and late pregnancy. Components of psychological distress were tested as independent risk factors with the development of a hypertensive disorder as the outcome. Results: There were no differences in psychological distress between hypertensive and normotensive women. Furthermore, no changes in psychological distress by time between groups were identified. However, this population did not present with significant symptoms of psychological distress. BMI was the only independent risk factor associated with an increased risk of developing a hypertensive disorder during pregnancy (OR = 1.13; 95% CI: 1.04–1.23, p = .003). Conclusions: These findings indicate psychological distress was not associated with the development of a hypertensive disorder during pregnancy in women with few symptoms of psychological distress. Women with higher BMI were at an increased risk of developing a hypertensive disorder.