Browsing by Subject "Pregnancy Complications"
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Item Predictors and Correlates of Anxiety in Women Hospitalized With High-Risk Pregnancy(2007-08-08) Labat, Dana Broussard; Evans, H.M.Anxiety during pregnancy often negatively impacts a woman's perception of her pregnancy, as well as affects the development of the fetus and contributes to long-term negative sequelae during subsequent years post-delivery. Despite the increases in attention to the effects of anxiety in the perinatal literature, few studies utilize women with high-risk pregnancy as their population of study. These women would appear to be at a greater risk of experiencing anxiety because of the physical and psychological demands of their complicated pregnancies. Therefore, the current study attempted to determine the demographic and psychosocial correlates of anxiety in this unique population. This investigation also sought to improve significant methodological limitations found in previous published reports by employing a "gold standard" clinical diagnostic interview in addition to self-report measures of anxiety. Finally, this study examined the course of anxiety across hospitalization. From October 2005 to December 2006, 129 participants admitted to a high-risk antenatal unit participated in this investigation. Of those participants, 12% were diagnosed with an anxiety disorder. This prospective investigation revealed significant associations among anxiety symptoms and younger maternal age, lower education and income level, and Medicaid insurance status. Further multivariate analyses revealed that relationship maladjustment, greater number of and elevated perceived distress of stressful life events, and the consideration of termination were also significantly associated with the presence of anxiety symptoms. Logistic regression analyses determined that endorsed depressive symptoms predicted more than a one-and-a-half time's likelihood of increased anxiety symptoms. These findings show that anxiety symptoms are present in women hospitalized with high-risk pregnancy and directly impact the experience of pregnancy. These results demonstrate that identifying potential risk factors of anxiety through routine screenings at initial admission could lead to the development of hospital-based short-term interventions aimed at preventing negative antenatal and postpartum outcomes.Item Predictors of Depression in a High-Risk Hospitalized Pregnancy Population: A Prospective Longitudinal Study(2007-08-08) Miltenberger, Paula Dianne; Evans, H.M.Research is beginning to elucidate the prevalence and effects of antenatal depression on the mother and fetus. However, relatively little focus has been paid to the woman diagnosed with a high-risk pregnancy requiring hospitalization. The present study investigated the predictors and trajectory of depression in women hospitalized on an antepartum unit. The sample consisted of 129 who were hospitalized due to complications during pregnancy. At admission, the women completed self-report measures to assess depressive symptoms, life events as well as personality. Women who exceeded set thresholds on depressive measures were administered a structural clinical interview to assess for a formal diagnosis of Major Depressive Disorder. Additionally, women's depressive symptoms were assessed weekly across hospitalization until discharge. Forty-four percent of the sample exceeded set threshold at admission, indicating they were experiencing high levels of depressive symptoms. Logistic regression was used to determine predictors of group status at admission, based on depressive measures. Results indicated that only life events were predictive of those women exceeding set thresholds. Furthermore, consideration of pregnancy termination and prior psychiatric diagnosis were predictive of Major Depressive Disorder. Growth curve modeling was used to identify trajectory and changes in depressive symptoms over the course of hospitalization. The results indicated that most women experienced a decrease in symptoms over time. In measuring personality, the Depressive Experiences Questionnaire (Blatt, D'Affliti, & Quinlan, 1976) was used to determine if women characterized as self-critical would report more depression during pregnancy than women characterized as dependent. No significant differences were found between the personality scales and depression severity. However, those women who were high on both self-criticism and dependency had the highest scores on the depressive measures. These results suggests that women who score high on both self-criticism and dependency scales appear to be the most vulnerable to depressive symptoms during the antepartum period.