@article{3125833,
    title = "Anxiety and depression symptoms among sub-fertile women, women pregnant after infertility treatment, and naturally pregnant women",
    author = "Salih Joelsson, L. and Tydén, T. and Wanggren, K. and Georgakis, M.K. and Stern, J. and Berglund, A. and Skalkidou, A.",
    journal = "European Psychiatry",
    year = "2017",
    volume = "45",
    pages = "212-219",
    publisher = "Elsevier Masson SAS",
    issn = "0924-9338",
    doi = "10.1016/j.eurpsy.2017.07.004",
    keywords = "adult;  alcohol consumption;  anxiety;  Article;  cohort analysis;  controlled study;  cross-sectional study;  depression;  distress syndrome;  Edinburgh Postnatal Depression Scale;  exercise;  female;  Hospital Anxiety and Depression Scale;  human;  infertility;  infertility therapy;  lifestyle;  major clinical study;  pregnancy;  pregnant woman;  prevalence;  priority journal;  questionnaire;  risk factor;  smoking;  symptom;  anxiety;  depression;  infertility;  pregnancy;  pregnancy complication;  psychological rating scale;  psychology;  young adult, Adult;  Anxiety;  Cross-Sectional Studies;  Depression;  Female;  Humans;  Infertility;  Pregnancy;  Pregnancy Complications;  Pregnant Women;  Prevalence;  Psychiatric Status Rating Scales;  Risk Factors;  Surveys and Questionnaires;  Young Adult",
    abstract = "Background Infertility has been associated with psychological distress, but whether these symptoms persist after achieving pregnancy via assisted reproductive technology (ART) remains unclear. We compared the prevalence of anxiety and depressive symptoms between women seeking for infertility treatment and women who conceived after ART or naturally. Methods Four hundred and sixty-eight sub-fertile non-pregnant women, 2972 naturally pregnant women and 143 women pregnant after ART completed a questionnaire in this cross-sectional study. The Anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A≥8) and Edinburgh Postnatal Depression Scale (EPDS≥12) were used for assessing anxiety and depressive symptoms, respectively. Multivariate Poisson regression models with robust variance were applied to explore associations with anxiety and depressive symptoms. Results The prevalence of anxiety and depressive symptoms among sub-fertile, non-pregnant women (57.6% and 15.7%, respectively) were significantly higher compared to women pregnant after ART (21.1% and 8.5%, respectively) and naturally pregnant women (18.8% and 10.3%, respectively). History of psychiatric diagnosis was identified as an independent risk factor for both anxiety and depressive symptoms. The presence of at least one unhealthy lifestyle behavior (daily tobacco smoking, weekly alcohol consumption, BMI≥25, and regular physical exercise < 2 h/week) was also associated with anxiety (Prevalence Ratio, PR: 1.24; 95%CI: 1.09–1.40) and depressive symptoms (PR: 1.25; 95%CI: 1.04–1.49). Conclusions Women pregnant after ART showed no difference in anxiety and depressive symptoms compared to naturally pregnant women. However, early psychological counseling and management of unhealthy lifestyle behaviors for sub-fertile women may be advisable, particularly for women with a previous history of psychiatric diagnosis. © 2017"
}