Severity of anxiety-depressive disorders in pregnant women with various obstetric anamnesis. (Original study)

Objective. To determine whether the level of anxiety-depressive symptoms in pregnant women differs depending on the severity of the obstetric history (one pregnancy loss, habitual miscarriage) compared with patients with a physiological pregnancy and a successful reproductive history. Materials and methods. A single-center comparative cross-sectional study was conducted on the basis of the Department of gynecology and the day hospital of R.A. Karimov maternity hospital No. 2 in Makhachkala during the period from November 2025 to December 2025. The study included 45 pregnant women divided into three groups: the comparison group (n=15) — patients with a physiological pregnancy, a successful obstetric history, hospitalized for extragenital pathology in the compensation stage; the “One loss” group (n=18) — women with one episode of spontaneous miscarriage; The Habitual Miscarriage group (n=12) consisted of women with a history of two or more spontaneous miscarriages. The psychoemotional state was assessed using the Hospital Anxiety and Depression Scale (HADS). Statistical analysis was performed using nonparametric methods (the Kraskel—Wallis criterion, the Mann—Whitney criterion with the Bonferroni correction). Quantitative data are presented in the form of median and interquartile range (Me; q1; q3). Results. Statistically significant intergroup differences in anxiety (HADS-A) (p=0.028) and depression (HADS-D) (p=0.027) were revealed. The highest median scores of anxiety and depression were recorded in the habitual miscarriage group: 9.5 (6.5; 14.5) and 7.5 (5.5; 12.0), respectively. A pairwise comparison showed that the habitual miscarriage group was statistically significantly different from the comparison group in terms of anxiety (p=0.012) and depression (p=0.015). The proportion of patients with clinically pronounced anxiety (≥11 points) in the habitual miscarriage group was more than 1/3 of women, with clinically pronounced depression — a quarter of the patients in the group. The differences between the group with one loss and the comparison group did not reach statistical significance (p>0.017). Conclusion. Pregnant women with a history of habitual miscarriage (two or more miscarriages) have the highest level of anxiety-depressive symptoms compared to patients with a physiological pregnancy and a successful reproductive history. A single pregnancy loss is associated with an intermediate level of disorders without statistically significant differences from the comparison group. The presence of clinically pronounced anxiety-depressive symptoms in individual patients of the comparison group justifies the expediency of routine psychological screening (HADS) in all pregnant women. The limitations of the study (small sample, single-center design) require further multicenter studies.