Preeclampsia as an Independent and Major Risk Factor for Significant Postpartum Depression Symptomatology - Results from a Prospective Cohort Study

Q: What was the study’s main objective?

To determine whether preeclampsia independently increases the risk of significant postpartum depression symptomatology after accounting for key confounders.

Q: How did the study measure postpartum depression symptomatology?

Postpartum depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS), with a cutoff of EPDS ≥ 13.

Q: What did the adjusted analysis show about the relationship between preeclampsia and PPD risk?

Preeclampsia had a highly significant independent association with significant PPD symptoms, with 12.7-fold increased adjusted odds (AOR 12.7; 95% CI 5.1–31.7; p < 0.001).

Q: Which confounding factors were evaluated and did any show independent association?

Maternal age, chronic hypertension, and prepregnancy diabetes were evaluated; none showed a statistically significant independent association with PPD risk in the adjusted model.

Sep 30, 2026

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Preeclampsia is a severe hypertensive disorder associated with greater maternal psychiatric morbidity, yet prior studies disagree on whether it predicts postpartum depression independent of comorbidities such as chronic hypertension and diabetes. A prospective cohort study followed 180 women (33 with preeclampsia; 147 normotensive), excluding prior psychiatric history. Postpartum depression symptomatology was measured with EPDS (≥13). Multivariable logistic regression adjusted for maternal age, chronic hypertension, and prepregnancy diabetes, showing preeclampsia increased adjusted odds of significant PPD (AOR 12.7; 95% CI 5.1–31.7; p<0.001).

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Abstract

Background/Objectives

Methods

Results

Conclusions

Introduction

Article Preeclampsia as an Independent and Major Risk Factor for Significant Postpartum Depression Symptomatology: Results from a Prospective Cohort Study Larisa-Mihaela Holbanel 1,†, Adina Turcu-Stiolica 2, *, Daniela Gabriela Glavan 3,†, Sebastian Constantin Toma 4, * and Nicolae Cernea 5,‡ Academic Editor: Sigita Lesinskienë Received: 8 November 2025 Revised: 18 December 2025 Accepted: 30 December 2025 Published: 5 January 2026 Copyright: © 2026 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. 1 Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; [dr.larisamihaela@gmail.com](dr.larisamihaela@gmail.com) 2 Department of Pharmacoeconomics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania 3 Psychiatry Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; [daniela.glavan@umfcv.ro](daniela.glavan@umfcv.ro) 4 General Surgery Department, Dr. Constantin Andreoiu, Ploiesti County Emergency Hospital, 100097 Ploiesti, Romania 5 Department of Obstetrics-Gynecology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania * Correspondence: [adina.turcu@umfcv.ro](adina.turcu@umfcv.ro) (A.T.-S.); [tosecon@hotmail.com](tosecon@hotmail.com) (S.C.T.)† These authors contributed equally to this work. ‡ Prof. Dr. Nicolae Cernea has passed away (Dead) . Abstract Background/Objectives: Preeclampsia is a severe hypertensive disorder that has been linked to increased maternal psychiatric morbidity. However, existing literature remains inconsistent regarding whether this association is independent of underlying medical co-morbidities such as chronic hypertension and diabetes. Our objective was to precisely evaluate the Adjusted Odds Ratio (AOR) of developing Postpartum Depression symptomatology (probable PPD) following a diagnosis of preeclampsia in a prospectively tracked cohort, controlling for essential confounders. Methods: This prospective cohort study included 180 women (33 in the Preeclampsia group, 147 in the Normotensive reference group), with stringent exclusion of women with prior psychiatric history to reduce confounding. PPD was assessed postpartum using the Edinburgh Postnatal Depression Scale (EPDS ≥ 13 cutoff). Multivariable logistic regression was employed to calculate the AOR, adjusting for maternal age, chronic hypertension, and prepregnancy diabetes. Results: The multivariable analysis demonstrated a highly significant and independent association between the primary exposure and the outcome. Preeclampsia was associated with 12.7-fold increased odds of developing PPD (AOR: 12.7; 95% CI: 5.1–31.7; p < 0.001). In contrast, none of the included confounders—chronic hypertension (AOR: 1.96, p = 0.182), prepregnancy diabetes (AOR: 1.8, p = 0.372), or age (AOR: 0.99, p = 0.759)—showed a statistically significant independent association with PPD risk. The model achieved strong explanatory power (Nagelkerke R2 = 0.327; Omnibus Test p < 0.001). Conclusions: Preeclampsia represents a powerful and independent determinant of the risk for significant PPD symptomatology, substantially increasing the adjusted odds of the condition. These findings mandate that women with a history of preeclampsia be designated a high-risk group and receive immediate, mandatory, and intensified postpartum mental health surveillance and preferential access to specialized psychological support. Keywords: preeclampsia; postpartum; depression; mental health 1. Introduction Preeclampsia is a severe hypertensive disorder of pregnancy, affecting 2–8% of pregnancies worldwide, and remains one of the leading causes of maternal and perinatal morbidity and mortality [1,2] . Initially regarded as a condition confined to gestation, preeclampsia is now recognized as a systemic disorder with long

FAQs

What was the study’s main objective?

To determine whether preeclampsia independently increases the risk of significant postpartum depression symptomatology after accounting for key confounders.

How did the study measure postpartum depression symptomatology?

Postpartum depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS), with a cutoff of EPDS ≥ 13.

What did the adjusted analysis show about the relationship between preeclampsia and PPD risk?

Preeclampsia had a highly significant independent association with significant PPD symptoms, with 12.7-fold increased adjusted odds (AOR 12.7; 95% CI 5.1–31.7; p < 0.001).

Which confounding factors were evaluated and did any show independent association?

Maternal age, chronic hypertension, and prepregnancy diabetes were evaluated; none showed a statistically significant independent association with PPD risk in the adjusted model.

Sep 30, 2026

Upload by PakDamar76