Association Between Hypertensive Disorder in Pregnancy and Postpartum Depression

Hypertensive Disorder in Pregnancy

Authors

  • . Nafeesa Department of Gynaecology and Obstetrics, Liaquat Memorial Hospital, Kohat, Pakistan
  • Fouzia Gul Department of Gynaecology and Obstetrics, Liaquat Memorial Hospital, Kohat, Pakistan
  • Raazia Mehsud Department of Gynaecology and Obstetrics, Liaquat Memorial Hospital, Kohat, Pakistan
  • Fatima Bibi Department of Gynaecology and Obstetrics, Liaquat Memorial Hospital, Kohat, Pakistan
  • Nadia Mahmood Department of Gynaecology and Obstetrics, Liaquat Memorial Hospital, Kohat, Pakistan
  • Nazish Hussain Department of Gynaecology and Obstetrics, Liaquat Memorial Hospital, Kohat, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v6i2.2481

Keywords:

Postpartum Depression, Gestational Hypertension, Preeclampsia, Edinburgh Postnatal Depression Scale

Abstract

Gestational hypertension, preeclampsia, and eclampsia are suspected of spontaneously developing and being particularly critical for maternal and infant health.  New research indicates that these disorders may also elevate the probability of developing Postpartum Depression (PPD), which remains one of the serious mental health challenges in new mothers. Objective: To evaluate the prevalence of PPD in women with hypertensive disorders during pregnancy and to examine further the association of PPD with hypertensive disorders of pregnancy. Methods: This comparative cross-sectional study was conducted at the Obstetrics and Gynaecology Department, LMH, Kohat.  A total of 155 postnatal women between the ages of 15 and 40 between 2-6 weeks postpartum were included. PPD was evaluated using the Urdu translation of Edinburgh Postnatal Depression Scale (EPDS), with depression indicated by scores >10. SPSS version 25 for statistical analysis, Chi-square tests (p < 0.05) were performed. Results: Women suffering from hypertensive disorders showed significantly higher EPDS scores (mean value of 11.85 ± 3.00) in comparison to those of normotensive women (mean value of 8.71 ± 2.03, p = 0.001). Emotional neglect (p = 0.001) and previous depression (p = 0.001) as risk factors were significantly related to PPD. Hypertensive pregnancies were also linked to adverse neonatal outcomes, including lower birth weights (p = 0.001) and increased neonatal admissions (p = 0.001). Conclusions: Hypertensive disorders in pregnancy significantly increase the risk of PPD. Integrating mental health support into prenatal and postnatal care for hypertensive women may improve maternal psychological well-being and neonatal health outcomes.

References

Shah S. Hypertensive disorders in pregnancy. Obstetric and Gynecologic Nephrology: Women's Health Issues in the Patient with Kidney Disease. 2020 Jan: 11-23. doi: 10.1007/978-3-030-25324-0_2. DOI: https://doi.org/10.1007/978-3-030-25324-0_2

Spadarella E, Leso V, Fontana L, Giordano A, Iavicoli I. Occupational risk factors and hypertensive disorders in pregnancy: a systematic review. International Journal of Environmental Research and Public Health. 2021 Aug; 18(16): 8277. doi: 10.3390/ijerph18168277. DOI: https://doi.org/10.3390/ijerph18168277

Braunthal S and Brateanu A. Hypertension in pregnancy: Pathophysiology and treatment. SAGE Open Medicine. 2019 Apr; 7: 2050312119843700. doi: 10.1177/2050312119843700. DOI: https://doi.org/10.1177/2050312119843700

Wang Z, Liu J, Shuai H, Cai Z, Fu X, Liu Y et al. Mapping global prevalence of depression among postpartum women. Translational Psychiatry. 2021 Oct; 11(1): 543. doi: 10.1038/s41398-021-01663-6. DOI: https://doi.org/10.1038/s41398-021-01663-6

Ushida T, Tano S, Imai K, Matsuo S, Kajiyama H, Kotani T. Postpartum and interpregnancy care of women with a history of hypertensive disorders of pregnancy. Hypertension Research. 2024 Jun; 47(6): 1457-69. doi: 10.1038/s41440-024-01641-7. DOI: https://doi.org/10.1038/s41440-024-01641-7

Yang LY, Lin FJ, Katz AJ, Wang IT, Wu CH. Prenatal antidepressant use and the implication of hypertensive disorders during pregnancy. American Journal of Obstetrics and Gynecology. 2021 Dec; 225(6): 672-e1. doi: 10.1016/j.ajog.2021.06.003. DOI: https://doi.org/10.1016/j.ajog.2021.06.003

Liu Y, Zhang L, Guo N, Jiang H. Postpartum depression and postpartum post-traumatic stress disorder: prevalence and associated factors. BioMed Central Psychiatry. 2021 Dec; 21: 1-1. doi: 10.1186/s12888-021-03432-7. DOI: https://doi.org/10.1186/s12888-021-03432-7

Nayak D, Karuppusamy D, Maurya DK, Kar SS, Bharadwaj B, Keepanasseril A. Postpartum depression and its risk factors in women with a potentially life‐threatening complication. International Journal of Gynecology & Obstetrics. 2021 Sep; 154(3): 485-91. doi: 10.1002/ijgo.13549. DOI: https://doi.org/10.1002/ijgo.13549

Lahti-Pulkkinen M, Girchenko P, Robinson R, Lehto SM, Toffol E, Heinonen K et al. Maternal depression and inflammation during pregnancy. Psychological Medicine. 2020 Aug; 50(11): 1839-51. doi: 10.1017/S0033291719001909. DOI: https://doi.org/10.1017/S0033291719001909

Sarosh M, Ghafoor F, Shakoor S. Association between Hypertensive Disorders in Pregnancy and Postpartum Mental Health. Pakistan Journal of Medical & Health Sciences. 2022 Mar; 16(02): 42-. doi: 10.53350/pjmhs2216242. DOI: https://doi.org/10.53350/pjmhs2216242

Dachew BA, Scott JG, Alati R. Hypertensive disorders during pregnancy and perinatal mental health symptoms. Journal of Affective Disorders Reports. 2021 Dec; 6: 100245. doi: 10.1016/j.jadr.2021.100245. DOI: https://doi.org/10.1016/j.jadr.2021.100245

Addo KM. The association between hypertensive disorders of pregnancy and postpartum depression in Ghana (Doctoral dissertation, University of West London). 2024 May.

Vilotić A, Nacka-Aleksić M, Pirković A, Bojić-Trbojević Ž, Dekanski D, Jovanović Krivokuća M. IL-6 and IL-8: an overview of their roles in healthy and pathological pregnancies. International Journal of Molecular Sciences. 2022 Nov; 23(23): 14574. doi: 10.3390/ijms232314574. DOI: https://doi.org/10.3390/ijms232314574

Ravi M, Bernabe B, Michopoulos V. Stress-related mental health disorders and inflammation in pregnancy: the current landscape and the need for further investigation. Frontiers in Psychiatry. 2022 Jun; 13: 868936. doi: 10.3389/fpsyt.2022.868936. DOI: https://doi.org/10.3389/fpsyt.2022.868936

Gebremariam L. Postpartum Depression:"sufferers' point of view". 2022.

Rocha de Moura MD, Margotto PR, Nascimento Costa K, Carvalho Garbi Novaes MR. Hypertension induced by pregnancy and neonatal outcome: Results from a retrospective cohort study in preterm under 34 weeks. PLOS One. 2021 Aug; 16(8): e0255783. doi: 10.1371/journal.pone.0255783. DOI: https://doi.org/10.1371/journal.pone.0255783

Lin YW, Lin MH, Pai LW, Fang JW, Mou CH, Sung FC et al. Population-based study on birth outcomes among women with hypertensive disorders of pregnancy and gestational diabetes mellitus. Scientific Reports. 2021 Aug; 11(1): 17391. doi: 10.1038/s41598-021-96345-0. DOI: https://doi.org/10.1038/s41598-021-96345-0

Hofheimer JA, McGowan EC, Smith LM, Meltzer-Brody S, Carter BS, Dansereau LM et al. Risk Factors for Postpartum Depression and Severe Distress among Mothers of Very Preterm Infants at NICU Discharge. American Journal of Perinatology. 2024 Jul; 41(10): 1396-408. doi: 10.1055/s-0043-1768132. DOI: https://doi.org/10.1055/s-0043-1768132

Akbar S. Stress and its associated factors in mothers with preterm infants in a private tertiary care hospital of Karachi, Pakistan. 2024 Nov; 14(11): e091117. doi: 10.1136/bmjopen-2024-091117. DOI: https://doi.org/10.1136/bmjopen-2024-091117

Pan Y, Ni L, Fang S, Zhang J, Fan W, Shen F. Effect of comprehensive care on the negative emotions and life quality in parturients with postpartum depression and gestational hypertension. American Journal of Translational Research. 2021 Jun; 13(6): 7228–7234.

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Published

2025-02-28
CITATION
DOI: 10.54393/pjhs.v6i2.2481
Published: 2025-02-28

How to Cite

Nafeesa, ., Gul, F., Mehsud, R., Bibi, F., Mahmood, N., & Hussain, N. (2025). Association Between Hypertensive Disorder in Pregnancy and Postpartum Depression: Hypertensive Disorder in Pregnancy. Pakistan Journal of Health Sciences, 6(2), 218–223. https://doi.org/10.54393/pjhs.v6i2.2481

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