The Correlation Between Anxiety and Depression Levels and Functional Capacity in Pregnant Women with Cardiac Disease Alona Winkler Smadar Truman Michal J. Simchen Hana Kerzman Rafael Kuperstein. Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Israel Background Anxiety and Stress increase in pregnancy when cardiac function is diminished Pregnant women with heart disease tend to suffer from complications Pregnancy causes a significant, permanent increase in heart function (cardiac output) The Importance of this Research The findings of this study will impact on setting up an interventional, follow-up program. A combined multidisciplinary team, which would include both cardiac and gynecological expertise Goal 1. To evaluate anxiety and stress levels 2. To evaluate the functional capacity according to the New York Heart Association (NYHA) functional class guidelines 3. To evaluate the relationship between functional capacity and anxiety and stress levels 4. To map the cardiac complications during pregnancy and after delivery Assumption We hypothesized that there is a direct correlation between functional capacity (NYHA) and anxiety and depression. We hypothesized that there is a direct correlation between cardiac complications during pregnancy and after delivery, and levels of anxiety and depression. Methods A follow-up longitudinal study among pregnant women at 3 different time points. Study population: 47 pregnant women with cardiac disease treated at the Leviev Heart Center, Sheba Medical Center at Tel Hashomer Population Pregnant Women with Heart disease N= 114 Not suitable N=67 3 Withdrew Suitable N=47 Answered the First & Second Questionnaire N =44 Answered the Third Questionnaire after delivery N=44 Demographic Characteristics N % 20-30 14 31.8 31-40 19 65.9 41-50 1 2.3 Unmarried 3 6.8 Married 41 93.2 High School 11 26.8 Academic 30 73.2 Working 32 78.0 Full Job 28 87.5 Normal Delivery 22 50.0 First Delivery 14 31.8 Age Familial Status Education woman’s Diagnosis Disease N % Valvular Disease 13 29.5 CMP 10 22.7 Low Cardiac out put after chemotherapy 1 2.27 Other cardiac problems All 20 45.4 44 100 Tools Demographic Questionnaire Anxiety Questionnaire (Spielberger, 1970 ) Depression Questionnaire (The Beck Depression Inventory ) Functional Capacity - New York Heart Association functional (Classification NYHA ). The study was conducted in 3 stages ; After 3 months of pregnancy After 6 months of pregnancy 1 month post delivery. Results p=0.015. First Trimester Second Trimester After Delivery Class I N= 39(86%) N=27 (66%) N=39 (88.6%) Class II N= 4 ( 9% ) N=10 (23%( N=3 (6.8) Class III N= 1 (2%) N=3 (7% ) N=1 (2.3) Level of Anxiety during the 3 stages of the study 40 34.5 34 30 31.1 20 10 0 1st Trimester 2nd Trimester After Delivery The relation between anxiety and Functional Capacity Conclusions The study was limited by the small sample size. we recommend a further study emphasizing on this group of women. In the light of our findings we plan a follow up study from start of pregnancy to deal with the complex problem of anxiety in high risk pregnant women.
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