Association of depression, anxiety, and insomnia in hypertensive disorders in pregnant women

Table 1 Depressive symptoms in hypertensive disorders in pregnancy-affected pregnant women, n (%)/M[Q1, Q3]

Depression status
Normal (0-4 points)	97 (79.51)
Mild depression (5-9 points)	25 (20.49)
Moderate depression (10-14 points)	0 (0.00)
Severe depression (15-19 points)	0 (0.00)
Extremely severe depression (20-27 points)	0 (0.00)
Depression (5-27 points)	25 (20.49)
Total Patient Health Questionnaire-9 score (0-27 points)	4.00 (3.00, 4.00)

Table 2 Anxiety status in hypertensive disorders in pregnancy-affected pregnant women, n (%)/M[Q1, Q3]

Anxiety status
Normal (0-4 points)	92 (75.41)
Mild anxiety (5-9 points)	30 (24.59)
Moderate anxiety (10-14 points)	0 (0.00)
Severe anxiety (15-21 points)	0 (0.00)
Anxiety (5-21 points)	30 (24.59)
Total Generalized Anxiety Disorder-7 score (0-21 points)	4.00 (3.00, 4.25)

Table 3 Insomnia-related parameters in hypertensive disorders in pregnancy-complicated pregnancies, n (%)/M[Q1, Q3]

Insomnia status	12-16 weeks	24-28 weeks	32-36 weeks	F/χ2	P value
Sleep duration (minutes)	464.86 ± 50.41	430.98 ± 61.76	411.28 ± 59.23	27.250	< 0.001
Sleep efficiency (%)	84.38 ± 8.87	77.33 ± 10.86	69.88 ± 12.85	53.200	< 0.001
Total Pittsburgh Sleep Quality Index score (0-21 points)	6.00 (4.00, 9.00)	8.00 (5.00, 10.00)	10.00 (7.00, 13.00)	27.416	< 0.001
Poor sleep quality (> 5 points)	74 (60.66)	87 (71.31)	100 (81.97)	13.542	0.001

Table 4 Univariate assessment of potential contributors to depressive and anxiety symptoms among pregnant women diagnosed with hypertensive disorders in pregnancy

Variable	Pittsburgh Sleep Quality Index (score)
	12-16 weeks	24-28 weeks	32-36 weeks
Patient Health Questionnaire-9 (score)	r = 0.302, P < 0.001	r = 0.298, P < 0.001	r = 0.282, P = 0.002
Generalized Anxiety Disorder-7 (score)	r = 0.228, P = 0.012	r = 0.411, P < 0.001	r = 0.402, P < 0.001

Table 5 Univariate assessment of potential contributors to depressive and anxiety symptoms among pregnant women diagnosed with hypertensive disorders in pregnancy, n (%)

Variable	Number	Anxiety/depression group (n = 50)	Normal control group (n = 72)	χ2	P value
Maternal age (years)				3.642	0.056
< 35	73	35 (70.00)	38 (52.78)
≥ 35	49	15 (30.00)	34 (47.22)
Gestational age (weeks)				3.046	0.081
< 37	52	26 (52.00)	26 (36.11)
≥ 37	70	24 (48.00)	46 (63.89)
Educational background				1.999	0.157
Senior high school or below	47	23 (46.00)	24 (33.33)
Above senior high school	75	27 (54.00)	48 (66.67)
Previous hypertensive disorders in pregnancy history				6.367	0.012
No	110	41 (82.00)	69 (95.83)
Yes	12	9 (18.00)	3 (4.17)
Spousal care level				5.612	0.018
Low	75	37 (74.00)	38 (52.78)
High	47	13 (26.00)	34 (47.22)
Pittsburgh Sleep Quality Index (points)				8.715	0.003
≤ 5	84	27 (54.00)	57 (79.17)
> 5	38	23 (46.00)	15 (20.83)
Monthly income (yuan)				5.686	0.017
< 4000	74	24 (48.00)	50 (69.44)
≥ 4000	48	26 (52.00)	22 (30.56)

The data for Pittsburgh Sleep Quality Index > 5 represents the count of patients experiencing poor sleep quality across all gestational stages.

Table 6 Independent predictors of depression and anxiety in hypertensive disorders in pregnancy-complicated pregnancies by multivariate analysis

Variable	B	SE	Wald	P value	Odds ratio (95%CI)
Previous hypertensive disorders in pregnancy history	1.587	0.773	4.213	0.040	4.887 (1.074-22.234)
Spousal care level	-0.971	0.450	4.656	0.031	0.379 (0.157-0.915)
Pittsburgh Sleep Quality Index (points)	1.135	0.457	6.177	0.013	3.113 (1.271-7.620)
Monthly income (yuan)	-1.480	0.458	10.451	0.001	0.228 (0.093-0.558)