Hendriks, Sanne

Slaapproblemen bij zwangere vrouwen met een psychiatrische stoornis.

Aanleiding:
Slaapproblemen tijdens de zwangerschap komen vaak voor en zijn geassocieerd met een verhoogd risico op depressie, angst, hart- en vaatziekten, diabetes, meer pijn tijdens de bevalling, sectio, vroeggeboorte en lager geboortegewicht. Zwangere vrouwen met een psychiatrische stoornis hebben een extra verhoogd risico op een decompensatie wanneer er bij hen ook sprake is van slaapproblematiek. Interventies zoals psycho-educatie over slaaphygiëne, cognitieve gedragstherapie, farmacotherapie en mindfulness worden geadviseerd maar er is geen richtlijn bekend waarin behandelopties staan vermeld of hoe deze in te zetten.

Associations between depressive and anxiety symptoms and neonatal outcomes

Introduction: Maternal depression during pregnancy is associated with adverse neonatal outcomes, such as preterm birth and low birth weight. This has a high public health significance because preterm birth and low birth weight are leading causes of mortality and morbidity in infants. Furthermore, depression during pregnancy and in the postpartum period, can predict bonding difficulties. Although previous research showed that a depressive or anxiety disorder during pregnancy are associated with adverse neonatal outcomes most studies are based on a depressive or anxiety diagnosis and not on the level of experienced depressive and anxiety symptoms.

Study aim: The present study aimed to assess whether severity of anxiey and/or depressive symptoms during pregnancy is associated with adverse neonatal outcomes.

Methods: Data for this investigation are obtained from the outpatient clinic ‘Psychiatry and Pregnancy’ of Dimence mental health institute in the Netherlands. The sample consists of women with a current or lifetime diagnosis of depression and/or anxiety based on DSM 5 criteria. Variables include demographic and personal characteristics, depressive symptoms, anxiety symptoms, degree of support, level of perfectionism, obsession and compulsion symptoms and level of bonding between mother and child. Neonatal outcomes include preterm birth, low birth weight and Apgar score, and are obtained from the partus reports. Chi-square statistics for categorical and analyses of variance for continuous variables are used to compare characteristiscs across depressive disorder, anxiety disorder and comorbid depression/anxiety disorder. Associations between depressive and anxiety characteristics and neonatal outcomes are examined using logistic regression analyses. Analyses are corrected for covariates age, educational level, chronic somatic disease, alcohol/substance use, medication use and psychological treatment.