Investigating relationships between psychological distress and hypertensive disorders of pregnancy

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dc.contributor.advisorTomfohr-Madsen, Lianne
dc.contributor.authorShay, Matthew
dc.contributor.committeememberCampbell, Tavis
dc.contributor.committeememberGiesbrecht, Gerald
dc.contributor.committeememberDumanski, Sandra
dc.contributor.committeememberDitto, Blaine
dc.date2022-02
dc.date.accessioned2022-01-04T16:41:07Z
dc.date.available2022-01-04T16:41:07Z
dc.date.issued2021-12
dc.description.abstractBackground: Hypertensive disorders of pregnancy (HDP) are a leading cause of pregnancy-related death worldwide. Psychological distress has been implicated in the development and progression of hypertensive disorders in non-pregnant populations; however, while pregnancy is a time of increased physical and emotional stress for many people, our understanding of the role of psychological health and development of HDP is limited. This dissertation expands the literature investigating the relationship between psychosocial factors and HDP through three distinct projects. Methods: The first manuscript was a meta-analysis that systematically reviewed and analyzed all current research investigating the relationship between depression and anxiety experienced during pregnancy and associations with HDP. The second manuscript applied artificial intelligence-driven machine learning methods to create a predictive model of HDP that included biologic, demographic, and psychosocial characteristics. The third manuscript was an analysis of blood pressure trajectories over the course of pregnancy using a functional data analysis approach, with an exploratory investigation of baseline factors that could differentiate between them. Data for the second and third manuscripts was obtained through the Alberta Pregnancy Outcomes and Nutrition (APrON) study. Results: The meta-analysis literature search identified 6291 citations, and ultimately 44 studies were included that captured data from 61.2 million pregnancies. Depression and/or anxiety were associated with increased risk of HDP (RR=1.39; 95% CI, 1.25-1.54). The second analysis included 1108 participants, with 75 (6.8%) identified as having HDP at delivery. The model predicting HDP generated an average accuracy of 65% using exclusively biologic, demographic, physical and psychosocial characteristics. The highest ranked predictors were body mass index (BMI), nulliparity, weekly physical activity, stressful life events during pregnancy, and age. The third analysis of blood pressure trajectories during pregnancy detected three dominant patterns of blood pressure variation: late pregnancy (64.8% in SBP and 63.4% in DBP variance), early pregnancy (13.21% in SBP and 13.43% in DBP variance), and mid-pregnancy (8.51% in SBP and 8.63% in DBP variance). HDP were associated with a trajectory of increased blood pressure in late pregnancy. Conclusion: Understanding possible psychological contributions to hypertensive risk during pregnancy is critical given the high prevalence of these conditions and both the immediate and longstanding impact on maternal and fetal health. These investigations furthered the understanding of the relationship between psychological health and cardiovascular health during pregnancy.en_US
dc.identifier.citationShay, M. (2021). Investigating relationships between psychological distress and hypertensive disorders of pregnancy (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.en_US
dc.identifier.doihttp://dx.doi.org/10.11575/PRISM/39481
dc.identifier.urihttp://hdl.handle.net/1880/114248
dc.language.isoengen_US
dc.publisher.facultyArtsen_US
dc.publisher.institutionUniversity of Calgaryen
dc.rightsUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.en_US
dc.subjecthypertensive disorders of pregnancyen_US
dc.subjecthealth psychologyen_US
dc.subjectperinatal mental healthen_US
dc.subject.classificationObstetrics and Gynecologyen_US
dc.subject.classificationPsychology--Clinicalen_US
dc.subject.classificationPsychology--Physiologicalen_US
dc.titleInvestigating relationships between psychological distress and hypertensive disorders of pregnancyen_US
dc.typedoctoral thesisen_US
thesis.degree.disciplinePsychology – Clinicalen_US
thesis.degree.grantorUniversity of Calgaryen_US
thesis.degree.nameDoctor of Philosophy (PhD)en_US
ucalgary.item.requestcopytrueen_US
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