Anxiety in high-risk pregnancy ups risk of arterial stiffness, pre-eclampsia

Women with high-risk pregnancies who have anxiety are at increased risk of arterial stiffness and, potentially, pre-eclampsia, as suggested in a study.

Researchers conducted a secondary analysis of a prospective cohort study involving 235 pregnant women who were aged ≥35 years at baseline, had a history of pre-eclampsia, and had pre-existing hypertension, diabetes, and renal dysfunction. Those who had excessive alcohol or drug use and cardiovascular disease, as well as a history of pregnancy loss, were excluded.

The participants were recruited before 14 weeks of gestation and had to undergo follow-up evaluations every 4 weeks until delivery for the occurrence of arterial stiffness. Anxiety symptoms were assessed every trimester using the Beck Anxiety Inventory and by self-reported history of emotional disorders (anxiety/depression).

Study outcomes included arterial stiffness and wave reflection parameters, primarily carotid-femoral pulse wave velocity, and pre-eclampsia.

Among the 161 participants included in the secondary analysis, 35.4 percent had baseline anxiety symptoms. In a combined mixed-effects model, anxiety was associated with a significant increase in carotid-femoral pulse wave velocity across gestation (B, 0.27, 95 percent confidence interval [CI], 0.008–0.530; p=0.04). The association followed a severity-response pattern, such that greater anxiety severity correlated with increased arterial stiffness.

Pre-eclampsia occurred in 12 participants (7.5 percent). A nonsignificant trend of association was observed between anxiety and pre-eclampsia risk (odds ratio [OR], 2.77, 95 percent CI, 0.84–9.18). Notably, a history of emotional disorders contributed to a significant increase in pre-eclampsia risk (OR, 3.91, 95 percent CI, 1.14–13.40), independent of other risk factors.