Clinical Evaluation of Depression and Anxiety in Pregnancy and their Impact on Maternal and Fetal Outcome

Abstract

Background: Anxiety and depression are more likely to occur during pregnancy. Anxiety during pregnancy is associated
with negative outcomes in mothers and babies. Unfortunately, because anxiety is frequently used interchangeably with
depression, research focused purely on anxiety during pregnancy are not as extensive as those focusing on depression.
Objectives: To evaluate the depression and anxiety during pregnancy and post pregnancy up to 3 months and also to
study its impact on maternal health and foetal outcomes.
Methods: All women presenting to antenatal outpatient are included in this study with standard questionnaire method.
All those are followed up further for 3 months, post-pregnancy to evaluate the maternal and foetal health. A standard
questionnaire of depression and anxiety using Hospital anxiety and depression scale-HADS is given and the women at
risk are further evaluated with Edinburg post-natal depression scale-EPDS. Follow up is done to check foetal growth,
any pre-term delivery, mode of delivery, birth weight and maternal complications to additionally evaluate maternal and
foetal outcomes.
Results: According to HADS Score , Overall Anxiety was reported in 26% of the cases, in 8% it was borderline and
in 18% it was severe anxiety. Overall Depression according to HADS was 30%, It was borderline in 8% and in 22% of
the cases it was severe depression. The EPDS score in comparision with Gravida, Depression, HADS score for Anxiety
and depression, Maternal and neonatal complications was statistically significant. HADS and EPDS reported similar
percentage of depression.
Conclusion: Properly identifying the women who are at risk of developing prenatal anxiety and depression would allow
us to target those who might benefit from preventative and supportive measures. Furthermore, identifying the women at
risk would allow us to monitor them throughout their pregnancy and recognise early signs of depression and anxiety as
they develop, allowing us to intervene therapeutically if necessary.
Keywords: Antepartum, Post-partum, Anxiety, Depression, EPDS