Association of antenatal anxiety disorders with antenatal comorbidities and adverse pregnancy outcomes among clinic attendees at a tertiary-care hospital in Sri Lanka

Purpose: Evidence on the association between antenatal anxiety disorders (AADs) and adverse pregnancy outcomes with detection of AADs using the gold-standard is scarce despite being vital to make decisions on interventions. We aimed to determine this association in women attending tertiary-care ante...

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Main Authors: M Nirmala Priyadarshanie, Dulshika A. Waas, Sampatha Goonewardena, Chamara V. Senaratna, Sharaine Fernando
Format: Article
Language:English
Published: Elsevier 2023-03-01
Series:Heliyon
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2405844023011076
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author M Nirmala Priyadarshanie
Dulshika A. Waas
Sampatha Goonewardena
Chamara V. Senaratna
Sharaine Fernando
author_facet M Nirmala Priyadarshanie
Dulshika A. Waas
Sampatha Goonewardena
Chamara V. Senaratna
Sharaine Fernando
author_sort M Nirmala Priyadarshanie
collection DOAJ
description Purpose: Evidence on the association between antenatal anxiety disorders (AADs) and adverse pregnancy outcomes with detection of AADs using the gold-standard is scarce despite being vital to make decisions on interventions. We aimed to determine this association in women attending tertiary-care antenatal clinics in Sri Lanka. Material and methods: Presence/absence of AADs in a systematic random sample of 221 antenatal women attending routine antenatal clinics of a teaching hospital who participated in a questionnaire-validation study were confirmed by a psychiatrist. These women were followed up until the end of pregnancy. Information on antenatal comorbidities, adverse pregnancy outcomes was extracted from health records. The association between AADs with antenatal comorbidities and adverse pregnancy outcomes were reported using adjusted odds ratios (ORs) and 95%confidence intervals (CIs) generated from logistic regression models. Results: Mean (±SD) age of the women was 30 (±5.8) years. AADs were diagnosed in 81 (37%) women. Compared to women without AADs, those who had AADs were more at risk of pregnancy-induced hypertension (OR 6.1; 95% CI 1.2–31.9), gestational diabetes mellitus (OR 12.6; 95% CI 1.5–107.2), preterm labour (OR 4.3; 95% CI 1.4–13.0), prolonged labour (OR 19.0; 95% CI 7.1–51.1), lower segment caesarean section (OR 4.7; 95% CI 2.5–8.7) and low birthweight (OR 11.2; 95% CI 4.8–26.3). All miscarriages, stillbirths and assisted labour occurred exclusively in those with AADs. Conclusions: AADs are strongly associated with several adverse pregnancy outcomes. Causal pathways and effect of interventions for AADs must be explored in future research.
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spelling doaj.art-c5af1df45305477bb0f8178579e317f92023-04-05T08:18:58ZengElsevierHeliyon2405-84402023-03-0193e13900Association of antenatal anxiety disorders with antenatal comorbidities and adverse pregnancy outcomes among clinic attendees at a tertiary-care hospital in Sri LankaM Nirmala Priyadarshanie0Dulshika A. Waas1Sampatha Goonewardena2Chamara V. Senaratna3Sharaine Fernando4Department of Nursing & Midwifery, Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University, Rathmalana, Sri Lanka; Corresponding author.Department of Psychiatry, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri LankaDepartment of Community Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri LankaNon-Communicable Diseases Research Centre, University of Sri Jayewardenepura, Nugegoda, Sri LankaDepartment of Physiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri LankaPurpose: Evidence on the association between antenatal anxiety disorders (AADs) and adverse pregnancy outcomes with detection of AADs using the gold-standard is scarce despite being vital to make decisions on interventions. We aimed to determine this association in women attending tertiary-care antenatal clinics in Sri Lanka. Material and methods: Presence/absence of AADs in a systematic random sample of 221 antenatal women attending routine antenatal clinics of a teaching hospital who participated in a questionnaire-validation study were confirmed by a psychiatrist. These women were followed up until the end of pregnancy. Information on antenatal comorbidities, adverse pregnancy outcomes was extracted from health records. The association between AADs with antenatal comorbidities and adverse pregnancy outcomes were reported using adjusted odds ratios (ORs) and 95%confidence intervals (CIs) generated from logistic regression models. Results: Mean (±SD) age of the women was 30 (±5.8) years. AADs were diagnosed in 81 (37%) women. Compared to women without AADs, those who had AADs were more at risk of pregnancy-induced hypertension (OR 6.1; 95% CI 1.2–31.9), gestational diabetes mellitus (OR 12.6; 95% CI 1.5–107.2), preterm labour (OR 4.3; 95% CI 1.4–13.0), prolonged labour (OR 19.0; 95% CI 7.1–51.1), lower segment caesarean section (OR 4.7; 95% CI 2.5–8.7) and low birthweight (OR 11.2; 95% CI 4.8–26.3). All miscarriages, stillbirths and assisted labour occurred exclusively in those with AADs. Conclusions: AADs are strongly associated with several adverse pregnancy outcomes. Causal pathways and effect of interventions for AADs must be explored in future research.http://www.sciencedirect.com/science/article/pii/S2405844023011076Antenatal anxiety disorderICD-10Pregnancy outcomesSri Lanka
spellingShingle M Nirmala Priyadarshanie
Dulshika A. Waas
Sampatha Goonewardena
Chamara V. Senaratna
Sharaine Fernando
Association of antenatal anxiety disorders with antenatal comorbidities and adverse pregnancy outcomes among clinic attendees at a tertiary-care hospital in Sri Lanka
Heliyon
Antenatal anxiety disorder
ICD-10
Pregnancy outcomes
Sri Lanka
title Association of antenatal anxiety disorders with antenatal comorbidities and adverse pregnancy outcomes among clinic attendees at a tertiary-care hospital in Sri Lanka
title_full Association of antenatal anxiety disorders with antenatal comorbidities and adverse pregnancy outcomes among clinic attendees at a tertiary-care hospital in Sri Lanka
title_fullStr Association of antenatal anxiety disorders with antenatal comorbidities and adverse pregnancy outcomes among clinic attendees at a tertiary-care hospital in Sri Lanka
title_full_unstemmed Association of antenatal anxiety disorders with antenatal comorbidities and adverse pregnancy outcomes among clinic attendees at a tertiary-care hospital in Sri Lanka
title_short Association of antenatal anxiety disorders with antenatal comorbidities and adverse pregnancy outcomes among clinic attendees at a tertiary-care hospital in Sri Lanka
title_sort association of antenatal anxiety disorders with antenatal comorbidities and adverse pregnancy outcomes among clinic attendees at a tertiary care hospital in sri lanka
topic Antenatal anxiety disorder
ICD-10
Pregnancy outcomes
Sri Lanka
url http://www.sciencedirect.com/science/article/pii/S2405844023011076
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