Association between maternal pregnancy complications and long-term depressive and anxiety disorders: evidence from the UK millennium cohort study.

PURPOSE: Limited evidence exists on the association between maternal pregnancy complications and depressive and/or anxiety disorders in the longer term. We examined the association between pregnancy complications and later depressive and anxiety disorders.

METHODS

The study cohort consisted of mothers who participated in the UK Millennium Cohort Study. Pregnancy complications were self-reported at 9 months postpartum and categorised into 0, 1, 2, and 3 + complications. Follow-up surveys, including questions about clinically diagnosed depressive, and anxiety disorders were carried out at 3, 5,7,11, and 14 years postpartum. The primary outcome is the diagnosis of depressive and anxiety disorders, in the mother up to 14 years postpartum. We applied multivariable logistic regression models adjusting for several potential confounders.

RESULTS

10,510 mothers were included in the analyses, with n = 3935 (37%) of mothers experiencing at least one pregnancy complication. The fully adjusted odd ratios (aOR) were, [aOR, 1.54 (95% CI, 1.40-1.70)], [aOR, 1.70 (95% CI, 1.46-1.99)], [aOR, 2.11 (95% CI, 1.65-2.69)] for 1, 2, and 3 + pregnancy complications respectively. Bleeding in later pregnancy [OR, 1.33 (95% CI,1.08-1.65)], preeclampsia [OR, 1.43 (95% CI, 1.22-1.67)], threatened miscarriage [OR, 1.38 (95% CI, 1.16-1.64)], were associated with later depressive and anxiety disorders. No association was observed for gestational diabetes mellitus [OR, 1.01 (95% CI, 0.74-1.37)].

CONCLUSION

An increasing number of pregnancy complications was associated with higher odds of depressive and anxiety disorders up to 14 years postpartum. Efforts to minimise and manage multiple pregnancy complications may benefit women's long-term mental health.