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Anxiety and depression symptoms among sub-fertile women, women pregnant after infertility treatment, and naturally pregnant women

Published online by Cambridge University Press:  23 March 2020

L. Salih Joelsson ,
T. Tydén ,
K. Wanggren ,
M.K. Georgakis ,
J. Stern ,
A. Berglund  and
A. Skalkidou
L. Salih Joelsson
Affiliation:
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
T. Tydén
Affiliation:
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
K. Wanggren
Affiliation:
Department of Clinical Science, Intervention and Technology, Obstetrics and Gynecology, Karolinska Institutet, Stockholm, Sweden
M.K. Georgakis
Affiliation:
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Sweden
J. Stern
Affiliation:
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden Department of Health Promotion, Sophiahemmet University, Stockholm, Sweden
A. Berglund
Affiliation:
The National Centre for Knowledge of Men's Violence against Women, Uppsala University, Uppsala, Sweden
A. Skalkidou*
Affiliation:
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
*
*Corresponding author. Women’s and Children’s Health, Uppsala University, 75185 Uppsala, Sweden. E-mail address:[email protected] (A. Skalkidou).
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Abstract

Background:

Infertility has been associated with psychological distress, but whether these symptoms persist after achieving pregnancy via assisted reproductive technology (ART) remains unclear. We compared the prevalence of anxiety and depressive symptoms between women seeking for infertility treatment and women who conceived after ART or naturally.

Methods:

Four hundred and sixty-eight sub-fertile non-pregnant women, 2972 naturally pregnant women and 143 women pregnant after ART completed a questionnaire in this cross-sectional study. The Anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A≥8) and Edinburgh Postnatal Depression Scale (EPDS≥12) were used for assessing anxiety and depressive symptoms, respectively. Multivariate Poisson regression models with robust variance were applied to explore associations with anxiety and depressive symptoms.

Results:

The prevalence of anxiety and depressive symptoms among sub-fertile, non-pregnant women (57.6% and 15.7%, respectively) were significantly higher compared to women pregnant after ART (21.1% and 8.5%, respectively) and naturally pregnant women (18.8% and 10.3%, respectively). History of psychiatric diagnosis was identified as an independent risk factor for both anxiety and depressive symptoms. The presence of at least one unhealthy lifestyle behavior (daily tobacco smoking, weekly alcohol consumption, BMI≥25, and regular physical exercise < 2 h/week) was also associated with anxiety (Prevalence Ratio, PR: 1.24; 95%CI: 1.09–1.40) and depressive symptoms (PR: 1.25; 95%CI: 1.04–1.49).

Conclusions:

Women pregnant after ART showed no difference in anxiety and depressive symptoms compared to naturally pregnant women. However, early psychological counseling and management of unhealthy lifestyle behaviors for sub-fertile women may be advisable, particularly for women with a previous history of psychiatric diagnosis.

Keywords

AnxietyDepressionInfertilityPregnancyAssisted reproductive technology (ART)
Type
Original article
Information
European Psychiatry , Volume 45 , September 2017 , pp. 212 - 219
Copyright
Copyright © European Psychiatric Association 2017

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Footnotes

Abbreviations: ,ART, Assisted reproductive technology ,HADS, Hospital Anxiety and Depression Scale ,EPDS, Edinburgh Postnatal Depression Scale ,IVF, in vitro fertilization ,SD, standard deviation, PR, prevalence ratio, CI, confidence intervals, BMI, Body mass index, ICSI, intracytoplasmic sperm injection

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