Background
Hypertensive disorders of pregnancy (HDP) affect 5-10% of pregnancies and are associated with maternal and neonatal morbidity. However, longer-term mental health outcomes following HDP remain poorly understood.
Aim
To examine the prevalence of likely depression and/or anxiety disorders in women 3-4 years post-HDP.
Methods
The Blood Pressure Postpartum (BP2) trial assessed three lifestyle interventions following HDP, with participants followed to 3-4 years postpartum1. Mental health outcomes were assessed using the Edinburgh Postnatal Depression Scale (EPDS) and Generalised Anxiety Disorder-7 (GAD-7). The primary outcome was prevalence of depression and/or anxiety by scores above threshold (EPDS>12, GAD-7>9) 3-4 years postpartum. Subgroup analyses were conducted by HDP subtype, BP² intervention group, body mass index (BMI) category, and mental illness history. Longitudinal analyses at 6 months, 12 months, and 3-4 years postpartum were performed.
Results
Among 238 women, the prevalence of above-threshold depression and/or anxiety scores 3-4 years postpartum was 11.6% (95% CI 7.5-15.8). Women with prior mental illness had a significantly higher prevalence of depression (17.9% vs 5.1%, p=0.01) and anxiety (22.8% vs 3.4%, p<0.001). Prevalence did not differ significantly by intervention group, HDP subtype, or BMI category. Longitudinal analyses showed no significant changes across timepoints.
Conclusion
Approximately one in nine women had scores suggestive of depression and/or anxiety 3-4 years after HDP. While outcomes did not vary by HDP subtype, intervention allocation, or BMI category, women with a prior mental illness history were at increased risk, highlighting the need for targeted screening and support for this high-risk group.