Depression, anxiety, self-efficacy and self-esteem in high risk pregnancy

BACKGROUND: To evaluate the levels of depression, state and trait anxiety, selfefficacy, and self-esteem among women with high risk pregnancy due to previous adverse pregnancy outcomes (PAPOs) or pre-pregnancy diseases (PPD), before and after delivery, compared to controls. METHODS: An observational longitudinal study on psychological dimensions was conducted on 86 women attending a university referral centre for high risk pregnancy, by administering the Edinburgh Postnatal Depression Scale, the State and Trait Anxiety Inventory, the General Self-Efficacy Scale, and the Self-esteem Scale. A pre-test (in the third trimester of pregnancy) and a follow-up measurement session (one month after the delivery) were applied. PAPOs group, PPD group and controls were compared. RESULTS: The PAPOs group had higher levels of depression compared to the other groups, with above-threshold levels. However, a more relevant decrease in depression was found in the PAPOs group after delivery. Levels of self-efficacy and self-esteem were unexpectedly high during and after pregnancy in all the groups. CONCLUSIONS: A PAPO represents a risk factor for depression development during pregnancy, whereas a PPD seems to be less relevant in influencing affective dimensions. Surprisingly, all pregnant women, independently of the obstetric risk, showed high levels of self-efficacy and self-esteem.