Anxiety Disorder and Pregnancy Outcomes in Women Attending a Tertiary Care Hospital in Colombo
Posted: 6 Dec 2019
Date Written: December 3, 2019
Abstract
Anxiety disorder is common during pregnancy and may cause adverse pregnancy outcomes. The aim of this study was to determine the association between antenatal anxiety disorder and adverse pregnancy outcomes. Pregnant women (n=221) attending ANCs of Colombo South Teaching Hospital (CSTH) were recruited using systematic random sampling. Anxiety was diagnosed by a psychiatrist using International Classification of Diseases-10 criteria. Socio-demographic information was collected using an interviewer-administered questionnaire. Information on pregnancy outcomes were extracted from the labour-room records, bed-head tickets, and neonatal records.These outcomes included Pregnancy Induced Hypertension (PIH),gestational age at delivery, type of labour (spontaneous/assisted labour), mode of delivery (normal vaginal delivery/vacuum, forceps delivery/lower segment caesarean section), prolonged labour, miscarriages, stillbirths and birth weight.Odds ratios and the 95% confidence intervals (CIs) were calculated to describe the association between antenatal anxiety and pregnancy outcomes. Mean (SD) age of the women was 30 (±5.8) years and 53.7% were multiparous. Of them, 81 (37%) were diagnosed to have anxiety disorder. Of women with anxiety, 46% were in their 3rd trimester, 37% in 2nd trimester and 17% in 1st trimester. Mean (SD) birth weight of offspring of women with anxiety (2.45±0.54) was significantly less than that of women without anxiety (3.04±0.35Kg; p<0.001). Mean (SD) gestational age at the time of delivery for those with anxiety was significantly low (36.6±1.8weeks) than that for those without anxiety (38.7±1.4weeks; p<0.001). Pregnancy outcomes associated with anxiety were miscarriages (OR 1.1; 95% CI 1.01-1.1), preterm labour(gestational age<37 weeks-OR 11.5; 95% CI 4.2-31.5), PIH (OR 4.6;95% CI 1.2-17.8), prolonged labour (OR 18.4; 95% CI 7.3-46.2) and low birth weight (birth weight<2.5kg) (OR 15.2; 95% CI 6.02-38.3). Anxiety was not associated with stillbirths, spontaneous and assisted labour (p>0.05). Antenatal anxiety is associated with pregnancy outcomes such as miscarriages, preterm labour, PIH, prolonged labour and low birth weight. Their causal nature and interactions with other risk factors must be explored in future research.
Keywords: anxiety disorder, ICD-10, pregnancy outcomes, antenatal clinics, Sri Lanka
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