Learning Objective 1: The learner will made aware of the importance of the correlation between high risk pregnancy and depression and anxiety levels
Learning Objective 2: The learner will be aware of the need to establish a comprehensive program to follow up high risk cardiac pregnancies
The study aimed to evaluate anxiety and depression levels in pregnant women with cardiac disease; and their relationship with NYHA functional capacity
A follow-up longitudinal study that included 47 pregnant women with cardiac disease treated in our Heart Center (from a total of 114) was conducted in 3 stages ; after 3 and 6 months of pregnancy and 1 month post delivery . A questionnaire containing personal and medical details, an anxiety questionnaire (Spielberger 1970) and a depression questionnaire (Beck 1961) were utilized. Forty-four of the 47 patients answered all three questionnaires successfully. Data were collected and analyzed using SPSS software.
During the 1st trimester 38 women were in NYHA I, 4 in NYHA II and one in NYHA III. In the 2nd trimester, 29 were NYHA I, 10 NYHA II and 3 NYHA III. After delivery, 39 were NYHA I, 3 NYHA II and 1 NYHA III. For the whole cohort average depression and anxiety levels remained low (< 40) throughout pregnancy and there was a significant correlation between functional capacity and anxiety level (p<0.05). When compared to patients in NYHA class I, patients in NYHA class II-III showed more signs of depression and anxiety in all stages of pregnancy, p=0.014 .
There is a significant correlation between functional capacity, anxiety and depression levels during pregnancy and post- delivery in women with cardiac disease. Clinical deterioration is associated with an increase in depression and anxiety levels.