Long-term follow-up of psychosocial distress after early onset preeclampsia: the Preeclampsia Risk EValuation in FEMales cohort study

Figures & data

Figure 1. Flowchart of the PREVFEM study.

Table 1. Descriptives stratified by presence or absence of PE.

		PE	Non-PE	F/X^2	p values	Effect size^a^,^b
Sociodemographic factors
Age	533	43.62 (4.88)	43.35 (4.22)	0.46	0.499	0.001
With partner	533	95% (251)	93% (248)	1.06	0.303	0.045
Higher education	530	33% (88)	20% (53)	12.57	<0.001	0.154
Employment status	532
Fulltime	52	10% (27)	9% (25)	3.61	0.164	0.082
Part-time	387	76% (200)	70% (187)
Unemployed	93	14% (38)	21% (55)
Lifestyle factors
BMI [kg/m2]	526	26.23 (4.97)	25.09 (4.23)	8.01	0.005	0.015
Physical activity [active]	532	76% (200)	74% (197)	0.36	0.551	0.026
Current or previous smoker	533	22% (58)	19% (52)	0.50	0.479	0.031
Alcohol use [yes]	532	53% (140)	48% (129)	1.09	0.298	0.045
Use of psychotropic medication	533	7% (19)	9% (25)	0.82	0.365	0.039
Index pregnancy characteristics
Time since index pregnancy [years]	523	13.7 (3.7)	14.5 (2.7)	8.02	.005	0.015
First pregnancy	523	80% (210)	71% (184)	5.80	.016	0.105
Pregnancy duration [weeks]	519	31.2 (3.9)	39.7 (1.9)	974	<0.001	0.653
Preterm birth [< 37 weeks]	519	89% (231)	6% (15)	356	<0.001	0.828
Birth weight child [grams]	517	1462.6 (823.0)	3450.6 (637.1)	944	<0.001	0.647
Stillborn child/early neonatal death	517	14% (37)	3% (7)	22.5	<0.001	0.209

Mean (SD) or % (n) is shown.

a Effect sizes for continuous variables are reported as Partial Eta Squared (η2).

b Effect sizes for categorical variables are Cramer’s V.

Table 2. Psychosocial distress at follow-up stratified by the presence or absence of PE.

	N	PE	Non-PE	F/X^2	p values	Effect size^a^,Table Footnoteb
Psychological distress
Depressive symptoms	530	3.59 (3.65)	2.89 (3.54)	4.96	0.026	0.009
Mild depression ≥5	530	27% (71)	23% (61)	1.22	0.269	0.048
Anxiety	531	3.57 (3.69)	3.45 (3.95)	0.13	0.723	<0.001
Mild anxiety ≥5	531	31% (82)	27% (72)	0.97	0.325	0.043
Fatigue	530	20.29 (6.18)	19.14 (6.10)	4.67	0.031	0.009
Social support
Loneliness	532	15.42 (4.82)	15.04 (4.63)	0.83	0.362	0.002
Marital Quality	503	5.39 (5.81)	5.62 (6.89)	0.17	0.679	<0.001
Personality
Optimism	530	19.61 (6.54)	19.84 (6.57)	0.16	0.686	<0.001
Type D personality	532	20% (53)	16% (42)	1.65	0.199	0.056
Negative Affectivity	532	7.73 (5.73)	7.43 (5.63)	0.37	0.545	0.001
Social Inhibition	532	7.31 (5.91)	7.02 (5.35)	0.34	0.558	0.001

Mean (SD) or % (n) is shown.

a Effect sizes for continuous variables are reported as Partial Eta Squared (η2).

b Effect sizes for categorical variables are Cramer’s V.

Table 3. Associations of a history of PE with long-term follow-up psychosocial distress.

		Unadjusted estimate for PE			Adjusted for a priori covariates^a			Adjusted for additional covariates^b
		B (95% CI)	p	r^2adj	B (95% CI)	p	r^2adj	B (95% CI)	p	r^2adj
Psychological distress	N
Depressive symptoms	525	0.70 (0.09–1.32)	0.026	0.008	0.66 (0.04–1.29)	0.038	0.017	0.81 (0.20–1.42)	0.009	0.074
Anxiety	526	0.09 (−0.56–0.75)	0.779	−0.002	0.10 (-0.57– 0.77)	0.776	−0.005	0.20 (-0.46–0.87)	0.551	0.014
Fatigue	526	1.12 (0.07–2.18)	0.037	0.006	1.12 (0.05–2.19)	0.040	0.019	1.39 (0.35–2.43)	0.009	0.082
Social support
Loneliness	527	0.37 (−0.44–1.18)	0.369	<0.001	0.29 (−0.53–1.11)	0.488	0.013	0.46 (-0.34–1.27)	0.261	0.053
Marital Quality	499	−0.19 (−1.32–0.93)	0.736	−0.02	−0.39 (−1.53–0.74)	0.496	0.017	−0.36 (-1.50–0.79)	0.540	0.012
Personality
Optimism	525	−0.22 (−1.35–0.91)	0.703	−0.08	−0.32 (-1.48–0.83)	0.584	0.002	−0.42 (-1.57–0.74)	0.477	0.001
Type D personality^c	527	1.35 (0.86–2.10)	0.192	−0.003	1.29 (0.82–2.04)	0.268	0.007	1.40 (0.88–2.24)	0.159	0.058

a Findings adjusted for a priori chosen covariates age, higher education, and BMI.

b Findings adjusted for age, higher education, and BMI, and additionally for partner, being unemployed, and physical activity (active).

c Odds ratio (OR) with 95% CI. Bold typeface represents significant differences.

Table 4. The association of early PE with psychosocial factors, adjusted for presence of hypertension in 2009, and group by hypertension interaction.

		Adjusted for hypertension				Adjusted for hypertension and hypertension*group interaction
Psychosocial factor	N	B	95% CI	p	r^2adj	B	95% CI	p	r^2adj
Depression	516
Group [PE]		0.63	(−0.02–1.29)	0.057	0.013	0.35	(-0.40–1.10)	0.357	0.016
Hypertension		−0.50	(−1.24–0.24)	0.184		−1.28	(−2.52- −0.03)	0.045
Group*hypertension						1.17	(−0.35–2.69)	0.130
Anxiety	517
Group [PE]		0.22	(−0.49–0.93)	0.542	<0.001	0.05	(−0.76–0.86)	0.896	<0.001
Hypertension		−0.57	(−1.37–0.23)	0.162		−1.02	(−2.38–0.33)	0.138
Group*hypertension						0.68	(−0.96–2.33)	0.415
Fatigue	517
Group [PE]		0.92	(−0.21–2.05)	0.110	0.011	0.46	(−0.84–1.75)	0.489	0.013
Hypertension		−0.33	(−1.61–0.95)	0.612		−1.60	(−3.76–0.56)	0.146
Group*hypertension						1.92	(−0.71–4.54)	0.152
Loneliness	518
Group [PE]		0.25	(−0.61–1.12)	0.568	0.010	−0.24	(−1.23–0.75)	0.636	0.016
Hypertension		−0.13	(−1.11–0.85)	0.796		−1.47	(−3.13–0.18)	0.080
Group*hypertension						2.03	(0.02-4.04)	0.048
Marital quality	490
Group [PE]		−0.10	(-1.30–1.09)	0.863	0.007	−0.49	(−1.86–0.88)	0.481	0.008
Hypertension		−0.65	(-2.02–0.71)	0.347		−1.75	(−4.08–0.58)	0.141
Group*hypertension						1.63	(−1.18–4.45)	0.254
Optimism	516
Group [PE]		−0.41	(-1.62–0.80)	0.502	<0.001	−0.30	(−1.68–1.09)	0.675	<0.001
Hypertension		0.62	(-0.75–1.99)	0.372		0.95	(−1.38–3.29)	0.424
Group*hypertension						−0.49	(−3.34–2.35)	0.733
Type D^a	518	OR	95% CI	p	r^2Cox	OR	95% CI	p	r^2Cox
Group [PE]		1.49	(0.92–2.41)	0.103	0.019	1.47	(0.86–2.49)	0.155	0.019
Hypertension		0.59	(0.33–1.04)	0.068		0.55	(0.18–1.67)	0.292
Group*hypertension						1.09	(0.31–3.89)	0.891

B-values and 95% CI of B are reported, with p values and estimate of effect size ‘adjusted r²’.

Psychosocial factors are outcome variables, estimated by early PE versus non-PE, adjusted for age, education, and BMI (data not shown), and additionally adjusted for the presence of hypertension in 2009 (left columns) and group by hypertension interaction (right columns).

a For the dichotomized Type D personality, OR with 95% CI are reported, with p values and estimate of effect size ‘Cox and Snell r²’. Bold typeface represents significant differences.