Anxiety and depression among cesarean section patients and their association with hypertensive disorders

Abstract

Women scheduled for cesarean section suffer from anxiety and/or depression. These conditions pose great risk for maternal and fetal health. This study examined the prevalence and risk factors for pre-cesarean section anxiety and depression and their association with hypertensive disorders during pregnancy. A cross-sectional study was undertaken at four teaching hospitals. Generalized anxiety disorder and anticipatory anxiety were assessed using GAD-7 and a numerical rating scale, respectively. Depression was also assessed using the patient health questionnaire (PHQ-2). The prevalence of moderate-to-severe GAD, anticipatory anxiety, and possible major depression was 2.7%, 27%, and 6%, respectively. Existing generalized anxiety disorder (GAD) may be associated with an increase in the respondents’ anticipatory anxiety score by 0.55 points at p < 0.001. The presence of comorbidity, especially hypertensive disorders, was associated with a decrease in the odds of having moderate-to-severe anticipatory anxiety, possible major depression, and pre-surgery pain at p < 0.001. Moderate-to-severe anticipatory anxiety was more prevalent than GAD and possible major depression. It is expedient that pregnant women scheduled for cesarean sections are screened for mental health conditions, as this will inform appropriate pharmacological choices for their general health outcome during and after surgery.