(528) Association of antenatal anxiety, short sleep duration, and blood pressure parameters: a pilot study

Anxiety and short sleep are individually associated with hypertensive disorders of pregnancy, yet their interactive effect on specific blood pressure (BP) parameters are unknown. We evaluated the association between anxiety and BP, and the moderating effect of short sleep duration.

Study Design: We conducted a prospective pilot study of pregnant people between 16 to 36 weeks’ gestation between 2021-22. Anxiety was defined as State Trait Anxiety Inventory-State (STAI-S) score ≥ 40, and short sleep duration was defined as average sleep duration of < 5 hours per day obtained over 3 to 7 days from a wrist-worn actigraphy device. Primary outcomes were systolic (SBP), diastolic (DBP), and mean (MAP) non-invasive BP measurements from enrollment. Generalized estimating equations (GEE) were used to first assess anxiety (independent variable) and each BP parameter (dependent variables), accounting for age, body mass index, and antihypertensive medications (Model 1). These models were then repeated including short sleep and an interaction term for short sleep and anxiety as covariates (Model 2).

Results: Of 60 participants, 15 (25%) screened positive for anxiety and 36 (61%) had short sleep duration. In Model 1, anxiety was not significantly associated with any BP parameters. When short sleep was included in Model 2, all BP parameters were significantly associated with anxiety (SBP: beta 9.6, p=0.01, DBP: beta 8.1, p < 0.001, and MAP: beta 8.8, p < 0.001). No further significant statistical interaction was detected between short sleep duration and anxiety on BP (p-interaction SBP 0.12, DBP 0.24, and MAP 0.13) (Table 1).

Conclusion: Pregnant people with anxiety had 9.6 mmHg higher systolic, 8.1 mmHg higher diastolic, and 8.8 mmHg higher mean BPs than people without anxiety accounting for short sleep duration. Short sleep duration strengthened the association between anxiety and BP in this prospective cohort.