Miss Jie Shang1, Professor Amanda Henry1,2,3, Doctor Katie Harris1, Doctor Lynne Roberts2,4, Professor Maree Hackett1,3
1The George Institute for Global Health, UNSW, Sydney, Australia, 2Discipline of Women’s Health, School of Clinical Medicine, UNSW Medicine and Health, Sydney, Australia, 3Department of Women’s and Children’s Health, St George Hospital Sydney, Sydney, Australia, 4St George and Sutherland Clinical Campus, School of Clinical Medicine, UNSW Medicine and Health, Sydney, Australia
Biography:
Jie Shang is a PhD candidate studying women's postpartum mental health after pregnancy complications at the George Institute for Global Health of the University of New South Wales. She received a Bachelor of Science degree in psychology and a master of science degree in epidemiology at the University of Melbourne.
Abstract:
Background: Postpartum mental illnesses, including depression and anxiety, can cause chronic adverse maternal and child health outcomes. Hypertensive disorders of pregnancy (HDP), affecting 5-10% of pregnant women, are a leading cause of maternal morbidity and mortality globally. Evidence exists to suggest lifestyle interventions may improve women’s post-HDP mental health but is inconclusive [1]. The Blood Pressure Postpartum (BP2) study [2] examined effect of different intensities of lifestyle change 6 to12-months post-HDP, with secondary outcomes including maternal mental health, reported here.
Study aim(s): The primary aim was to compare mental health outcomes of women in three groups (brief education intervention, extended lifestyle intervention, and controls) at 12-months postpartum. Secondary aims included investigating mental outcomes across HDP subtypes (gestational hypertension, chronic hypertension, preeclampsia, and superimposed preeclampsia), and by history of mental illness versus not.
Methods: The three-armed BP2 study, at 6-months postpartum, recruited women with index pregnancy complicated by HDP from six metropolitan hospitals in Sydney, Australia. Mental outcomes (Edinburgh Perinatal Depression Scale (EPDS) score>12 for depression or General Anxiety Disorder-7 scale (GAD-7) score≥10 for anxiety), demographics, and other health related measures were compared between 6-months (baseline) and 12-months postpartum.
Results: Of total 413 women, mental illness was present in 7.3% (3.6% brief education, 11% extended lifestyle, 7.3% controls), with p=0.06 across groups, brief education vs controls p=0.32, extended lifestyle vs controls p=0.64 at 12-months postpartum. There was less mental illness at 12-months in the brief intervention group and controls than 6-months postpartum. No statistically significant mental illness differences were found across HDP subtypes. Mental illness history predicted 12-months postpartum mental illness (adjusted OR 3.8, 95%CI [1.6, 9.0], p<0.001).
Conclusion: Mental illness history is a strong predictor of postpartum mental risk. Lifestyle change interventions in this study did not significantly improve mental illness prevalence versus control.
Keywords
mental health, postpartum depression, hypertensive disorders of pregnancy (HDP)
References
1. Shang J, Dolikun N, Tao X, Zhang P, Woodward M, Hackett ML, Henry A: The effectiveness of postpartum interventions aimed at improving women’s mental health after medical complications of pregnancy: a systematic review and meta-analysis. BMC Pregnancy and Childbirth 2022, 22(1):809.
2. Henry A, Arnott C, Makris A, Davis G, Hennessy A, Beech A, Pettit F, Homer CS, Craig ME, Roberts L: Blood pressure postpartum (BP2) RCT protocol: follow-up and lifestyle behaviour change strategies in the first 12 months after hypertensive pregnancy. Pregnancy hypertension 2020, 22:1-6.