Key Factors Influencing Anxiety in Pregnant Women With Hypertension: Insights for Maternal Health Interventions
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Abstract
Introduction: Hypertensive disorders in pregnancy are a leading cause of maternal and perinatal morbidity and mortality, affecting approximately 10% of pregnancies. Anxiety frequently coexists with hypertension, intensifying risks to maternal and fetal health. However, evidence on factors influencing anxiety in hypertensive pregnancies, particularly in low-resource settings, remains limited. This study aimed to identify psychosocial, demographic, and obstetric factors associated with anxiety among hypertensive pregnant women. Materials and Methods: This cross-sectional study involved 135 hypertensive pregnant women in Kudus Regency, Indonesia. Anxiety levels were assessed using the Hamilton Rating Scale for Anxiety (HRS-A), and data on psychosocial, demographic, and obstetric factors were collected using validated questionnaires. Logistic regression was used to estimate the odds of experiencing moderate anxiety based on psychosocial and demographic characteristic. Results: The majority of participants were aged 20–35 years (86.7%), had low education levels (81.5%), and were employed (79.3%). Most respondents reported moderate anxiety (72.6%), while 27.4% experienced mild anxiety. Good knowledge (OR = 0.35; p = 0.048), positive attitudes (OR = 0.15; p = 0.001), good behaviors (OR = 0.28; p = 0.023), and higher education levels (OR = 0.29; p = 0.048) significantly reduced the likelihood of moderate anxiety. However, factors such as age, marital status, spousal support, midwife support, and a history of hypertension were not significantly associated with anxiety. Conclusion: Knowledge, attitudes, behaviors, and education levels were significantly associated with anxiety among hypertensive pregnant women. These findings highlight the importance of health education-based interventions to address maternal anxiety. Further longitudinal research is recommended to establish causal relationships and explore sociocultural factors influencing anxiety.
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