Skip to main content
SMFM 2025 Pregnancy Meeting Main banner
Final Program


Program Book
Icon Legend
Presentation Icons
Additional registration fee required
Additional registration fee required
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Poster Icons
Additional registration fee required
Additional registration fee required
Faculty have requested this content not be shared on social media
Faculty have requested this content not be shared on social media
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Back

Poster Session 4

(1204) Risk of HDP in nulliparas with treated versus untreated mood and anxiety disorders

Friday, January 31, 2025
4:00 PM – 6:00 PM  
Objective: The impact of mood and anxiety disorders (MAD) on the risk of developing hypertensive disorders of pregnancy (HDP) remains unclear. This study aimed to explore the risk of HDP in nulliparas with either treated or untreated MAD. 

Study Design: This was a secondary analysis of the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b). Nulliparas with singleton gestations ≥20 weeks without chronic hypertension were grouped as follows: no MAD, untreated MAD, and treated MAD. The diagnoses included in the MAD groups were depression, bipolar disorder, other mood disorders (dysthymia, seasonal affective disorder), and anxiety disorders (generalized anxiety disorder, panic disorder, obsessive-compulsive disorder). Treatment was defined as the use of a psychotropic medication for a psychiatric indication. The risk of HDP was compared between groups using univariate and multivariate analyses.

Results: Of the 8,492 patients included in the analysis, 6,877 (81.0%) had no MAD diagnosis, 1,014 (11.9%) had an untreated MAD, and 601 (7.1%) had a treated MAD. Patients with a treated MAD were more likely to be older (p< 0.001), white (p< 0.001), non-Hispanic (p< 0.001), college-educated (p=0.01), privately insured (p< 0.001), have a higher pre-pregnancy BMI (p=0.001), and score higher on the Edinburgh Postnatal Depression Scale (EPDS) in early pregnancy (p< 0.001). Compared to patients with no MAD, the risk of any HDP was similar across groups in both unadjusted and adjusted models (untreated MAD, aRR 0.96 [CI 0.85-1.08]; treated MAD, aRR 0.92 [CI 0.79-1.08]) (Table 1). The risk of preeclampsia was also not significantly different by MAD diagnosis or treatment exposure. To account for patients who may have undiagnosed or undertreated MAD, a multivariate model was created to examine the risk of any HDP or preeclampsia alone by EPDS score, which also showed no significant difference in risk (aRR 0.93 [CI 0.80-1.07]). 

Conclusion: This large cohort analysis found no significant statistical difference in the risk of HDP by MAD diagnosis, psychotropic treatment, or worst mood symptoms during pregnancy.