The Perinatal Anxiety Screening Scale was translated and validated for European Portuguese (PASS-29; Pereira et al. 2019), from the original PASS (composed of 31 items; Somerville et al. 2014) to allow epidemiological and correlational research and early detection, which is an health policy imperative. This need also applies to Brazil, where a specific instrument to measure perinatal anxiety is not available.

To study the psychometric properties of the PASS Brazilian version factor structure using confirmatory factor analysis (CFA), internal consistency and pattern of correlations with mood states.

350 women (Mean age: 30.01±5.452) in the second trimester of pregnancy (Mean weeks =25.17±±6.55) completed the PASS and the Brazilian version of Profile of Mood States (POMS-25; Barros et al. 2021). SPSS and AMOS software were used.

After deleting two items (1 and 2) and some errors correlated, CFA indicated a good fit for the second-order model (X2/df=2.987; CFI=.903; TLI=.889; GFI=.797, RMSEA=.075; p[rmsea≤0.01]<0.001). The Cronbach alpha was α=.937, and for the four dimensions (general anxiety and specific fear, perfectionism and control, social anxiety and adjustment disorder, acute anxiety and trauma.), were all α>.800. PASS total and dimensional scores significantly (p<.01) and moderately correlated with Profile of Mood States dimensions: negative affect (.471), Depression (.294), Anxiety (.548), Fatigue (.438) and Vigour (-.288).

Similarly, to what has been found for Portuguese version, the Brazilian PASS resulted in a 29-items-and-four-factors version, with good construct and convergent validity and reliability. In the near future we will determine the PASS cut-offs to screen for anxiety disorders in pregnancy and postpartum.

Psychosocial factors have been implicated as both a cause and consequence of hypertension in the general population but are less understood in relation to hypertensive disorders of pregnancy (HDP). The aims of this review were to (1) synthesize the existing literature examining associations between depression and/or anxiety in pregnancy and HDP and (2) assess if depression and/or anxiety in early pregnancy was a risk factor for HDP.

A comprehensive search of Medline, Embase, CINAHL, and PsycINFO was conducted from inception to March 2020 using terms related to ‘pregnancy’, ‘anxiety’, ‘depression’, and ‘hypertensive disorders’. English-language cohort and case-control studies were included if they reported: (a) the presence or absence of clinically significant symptoms of depression/anxiety, or a medical record diagnosis of depression or an anxiety disorder in pregnancy; (b) diagnosis of HDP; and/or (c) data comparing the depressed/anxious group to the non-depressed/anxious group on HDP. Data related to depression/anxiety, HDP, study characteristics, and aspects related to study quality were extracted independently by two reviewers. Random-effects meta-analyses of estimated pooled relative risks (RRs) were conducted for depression/anxiety in pregnancy and HDP.

In total, 6291 citations were retrieved, and 44 studies were included across 61.2 million pregnancies. Depression and/or anxiety were associated with HDP [RR = 1.39; 95% confidence interval (CI) 1.25–1.54].

When measurement of anxiety or depression preceded diagnosis of hypertension, the association remained (RR = 1.27; 95% CI 1.07–1.50). Women experiencing depression or anxiety in pregnancy have an increased prevalence of HDP compared to their non-depressed or non-anxious counterparts.