Obstetrical and Neonatal Outcomes in Pregnant Individuals With Anxiety Disorders

AIM: Anxiety disorders (AD) are increasingly prevalent among the general population and pregnant individuals. Previous research has supported evidence of adverse obstetrical and fetal outcomes associated with pregnancies affected by mental health conditions. However, these studies often combine multiple psychiatric disorders, making it difficult to delineate the specific contribution of ADs. The purpose of the current study is to characterize the impact of ADs on obstetrical and fetal/neonatal outcomes. METHODS: Data from the 2016-2021 Healthcare Cost and Utilization Project, Nationwide Inpatient Sample, an American population-based database, were used to perform a retrospective cohort study. Associations between pregnancies with ADs and obstetrical and newborn outcomes were examined using multivariable logistic regression models adjusted for baseline maternal characteristics. RESULTS: We identified 225 326 individuals with ADs and 4 112 286 individuals without ADs. The prevalence of ADs in pregnancy rose substantially from 3.1% to 8.1% of pregnancies between 2016 and 2021. Individuals with ADs were more likely to be Caucasian, had higher income, had private insurance, and had pre-existing comorbidities. ADs during pregnancy were associated with greater risks of multiple obstetrical complications including gestational hypertension, pre-eclampsia, preterm birth, postpartum hemorrhage, and longer hospital stay. Intrauterine growth restriction and congenital anomalies were more frequent among neonates born to individuals with ADs. CONCLUSIONS: Pregnant individuals with ADs are at greater risk of experiencing adverse obstetrical and neonatal outcomes. Hence, it is critical for healthcare providers to screen pregnant patients for ADs and to provide appropriate treatment.