Abstract
BACKGROUND: Insomnia in patients with hypertensive disorders in pregnancy (HDP) appears closely associated with depression and anxiety, though this relationship requires further validation. AIM: To examine the inter-relationships among depression, anxiety, and insomnia in women with HDP. METHODS: A total of 122 HDP cases were enrolled from January 2021 to January 2025. The Patient Health Questionnaire-9 (PHQ-9) was used to evaluate depressive symptoms, while the Generalized Anxiety Disorder-7 (GAD-7) assessed anxiety. Sleep duration, sleep efficiency, and insomnia were measured using the Pittsburgh Sleep Quality Index (PSQI). Spearman's r determined inter-scale correlations. Determinants influencing depression and anxiety were identified via univariate and multivariate analyses. RESULTS: Among the 122 women with HDP, 20.49% exhibited depression and 24.59% had anxiety. The mean PHQ-9 and GAD-7 scores were 4.00 (3.00, 4.00) and 4.00 (3.00, 4.25), respectively. As pregnancy progressed, participants showed reduced sleep duration and efficiency, higher PSQI total scores, and an increased proportion of poor sleepers. Across all gestational stages, PHQ-9 and GAD-7 scores were positively correlated with PSQI results. Depression and anxiety were independently associated with a prior HDP history, limited spousal support, PSQI > 5, and monthly income < 4000 yuan, as confirmed using both regression models. CONCLUSION: Depression and anxiety in HDP are positively and strongly to insomnia. Women with HDP face higher risk of depression and anxiety if they have a history of HDP, limited spousal support, PSQI > 5, or monthly income < 4000 yuan.