Placenta Previa is Associated with Maternal Psychological Distress: A Mediation Analysis of Depression, Anxiety, and Post-Traumatic Stress Symptoms

Zümrüt Çalışkan-Şenay,1 Şükrü Alperen Korkmaz,2 Merve Güler,1 Dilek Şahin1 1Department of Gynecology, Ankara Bilkent City Hospital, Ankara, Turkiye; 2Faculty of Medicine, Department of Psychiatry, Çanakkale Onsekiz Mart University, Çanakkale, TurkiyeCorrespondence: Şükrü Alperen Korkmaz, Faculty of Medicine, Department of Psychiatry, Çanakkale Onsekiz Mart University, Çanakkale, Turkiye, 17010, Tel +90533-3712772, Email [email protected]: Placenta previa (PP) is a major obstetric complication that can cause significant physical and emotional stress for expectant mothers. However, its psychological impact has received limited research attention. The purpose of this study was to examine perceived stress, depression, anxiety, post-traumatic stress symptoms, and sleep disturbances in patients diagnosed with PP.Methods: This cross-sectional study with prospectively collected obstetric outcomes included 70 cases of PP and 78 healthy pregnant women (HPs) in the third trimester of pregnancy. Depression, anxiety, post-traumatic stress symptoms, sleep disturbances, perceived stress, and resilience were assessed using the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Impact of Events Scale-Revised (IES-R), Jenkins Sleep Scale (JSS), Perceived Stress Scale (PSS-10), and Brief Resilience Scale (BRS), respectively.Results: According to the cutoff scores of the scales, 50%, 42.9%, 62.9%, and 51.4% of those diagnosed with PP met the criteria for depression, anxiety, sleep disturbances, and post-traumatic stress disorder, respectively, which were significantly higher than those in the HP group. After controlling for maternal age, gravida, parity, and resilience, the PHQ-9, GAD-7, and IES-R scale scores were significantly higher in patients with PP than in the HP group. The mediation model indicated that depression and anxiety partially mediate the relationship between perceived stress and post-traumatic stress symptoms (PSS-10 ➝ GAD-7/PHQ-9 ➝ IES-R).Conclusion: The findings of this study suggest that women diagnosed with PP who are anticipating labor have a significantly increased likelihood of developing depression, anxiety, sleep disturbances, and post-traumatic stress symptoms. Raising awareness of the adverse psychological effects associated with PP may help facilitate the implementation of screening, assessment, and intervention strategies for these patients.Keywords: pregnancy, prevalence, perinatal depression, high-risk, preterm, PTSD