Preeclampsia risk in relation to maternal mood and anxiety disorders diagnosed before or during early pregnancy

Background: Mood and anxiety disorders are common, debilitating psychiatric illnesses that disproportionally affect women of childbearing age. Relatively few studies have evaluated the extent to which, if at all, maternal mood and anxiety disorders are risk factors for preeclampsia, and results from available studies are inconsistent. We examined the risk of preeclampsia in relation to maternal medical history of mood and anxiety disorders. Methods: We used data from a cohort study of 2,601 pregnant women. Maternal pregestational and early pregnancy (before completion of 20 weeks gestation) psychiatric diagnoses were ascertained from medical records. Generalized linear regression procedures were used to derive relative risk (RR) estimates and 95% confidence intervals (CIs). Results: A positive history of maternal mood or anxiety disorder was associated with a 2.12-fold increased risk of preeclampsia after adjustment for age, race/ethnicity, and pre-pregnancy body mass index (95% CI 1.02-4.45). The risk of preeclampsia appeared to be more strongly related with maternal mood or anxiety disorders first diagnosed during the index pregnancy (adjusted RR = 3.64; 95% CI 1.13-11.68). The corresponding RR for maternal mood and anxiety disorders diagnosed before pregnancy was 1.73 (95% CI 0.71-4.20). Conclusions: Maternal mood and anxiety disorders are associated with increased preeclampsia risk. These observations must be explored in larger pharmacoepidemiological studies that allow precise evaluations of independent and joint effects of maternal psychopathologies and the use of psychotropic medications on preeclampsia risk.