Psychometric analyses in assisted reproductive technology (ART) pregnancies: insights from the nuMoM2b cohort.

OBJECTIVE

To investigate the association, if any, between conception through assisted reproductive technology (ART) and depression or anxiety in pregnancy.

DESIGN

Secondary analysis of the prospective nulliparous pregnancy outcomes study: monitoring mothers-to-be (nuMoM2b).

SUBJECTS: Nulliparous women with singleton pregnancies.

EXPOSURE: Patients who conceived through ART (n = 366) were compared with those who conceived naturally (n = 8,922).

MAIN OUTCOME MEASURES: Maternal depressive and anxiety symptoms as assessed by the Edinburgh Postnatal Depression Scale (EPDS) and the Perceived Stress Scale (PSS) at the first and third trimesters and the State Trait Anxiety Inventory (STAI) at the first trimester.

RESULTS

The ART group had significantly lower EPDS and PSS scores compared with the non-ART group in the first and third trimesters. In unadjusted analysis, patients who conceived with ART were less likely to experience significant depressive symptoms, with EPDS ≥10 rates of 8.2% vs. 18.3% in the first trimester and 8.6% vs. 16.5% in the third trimester for ART and non-ART groups, respectively. High perceived stress (PSS 27-40) was also less common among ART patients, occurring in 0.5% vs. 3.7% in the first trimester and 0.6% vs. 2.4% in the third trimester. However, after adjustments, the ART group had similar significant depression rates both in the first and third trimesters compared with the non-ART group. Likewise, in adjusted analysis, high perceived stress rates were similar between the 2 groups in both trimesters. There were no significant differences in the STAI questionnaire responses in the unadjusted or adjusted analysis.

CONCLUSION

Patients who conceive with ART display similar depression symptoms during the first and third trimesters of pregnancy compared with those with unassisted conception. Additionally, perceived stress is comparable in both the first and third trimesters between the 2 groups.