A new study has found that individuals diagnosed with depression during pregnancy have a higher risk of developing cardiovascular disease within two years postpartum. The study emphasizes the importance of using pregnancy as a window to future health, recommending that those with prenatal depression be aware of their long-term cardiovascular health and implement prevention strategies.
According to a recent study published in the Journal of the American Heart Association, individuals who suffered from depression during pregnancy were found to have a higher likelihood of being diagnosed with cardiovascular disease within two years post-partum.
- A study of more than 100,000 people in the U.S. has found an association between individuals’ psychological well-being during pregnancy and their risk of developing cardiovascular disease within two years of delivery.
- The most significant association was between depression and ischemic heart disease, with individuals with depression having an 83% higher risk of developing the condition than those without a depression diagnosis.
- The increased risk of cardiovascular disease was found even among individuals without high blood pressure during pregnancy.
According to a recent study published in the Journal of the American Heart Association, individuals diagnosed with depression during pregnancy have a higher likelihood of being diagnosed with cardiovascular disease within two years of giving birth compared to those without depression.
It is well known that depression can have detrimental impacts on cardiovascular health in the general population. Research has shown that both men and women who experience depression have a higher likelihood of developing heart disease in the future. Previous research has also revealed that roughly 20% of people go through depression during pregnancy. Despite this, there has been limited investigation into the link between prenatal depression and the increased risk of cardiovascular disease.
“We need to use pregnancy as a window to future health,” said lead study author Christina M. Ackerman-Banks, M.D., an assistant professor of obstetrics and gynecology-maternal fetal medicine at Baylor College of Medicine and Texas Children’s Hospital in Houston. “Complications during pregnancy, including prenatal depression, impact long-term cardiovascular health. The postpartum period provides an opportunity to counsel and screen people for cardiovascular disease in order to prevent these outcomes.”
This study is the first population-based study to primarily investigate the relationship between prenatal depression and postpartum cardiovascular disease diagnosis within the first two years postpartum. The research team analyzed data from the Maine Health Data Organization’s All Payer Claims Database for over 100,000 individuals who gave birth in Maine between 2007 and 2019. The researchers aimed to estimate the cumulative risk of new cardiovascular disease diagnoses within two years after delivery.
After adjusting for potential confounding factors such as smoking, age at the time of delivery and pre-pregnancy diabetes, pre-pregnancy depression, pre-pregnancy hypertension, and preeclampsia, the researchers estimated the risk of developing six major cardiovascular conditions — heart failure, ischemic heart disease, arrhythmia/cardiac arrest, cardiomyopathy, stroke, and high blood pressure — within two years of delivery.
The analysis found that the estimated cumulative cardiovascular disease risk for heart failure, ischemic heart disease, cardiomyopathy, arrhythmia/cardiac arrest, or newly diagnosed high blood pressure within two years of delivery was significantly higher for people with depression compared to the people without depression. People with prenatal depression had:
- an 83% higher risk of ischemic heart disease (issues caused by narrowed heart arteries supplying blood to the heart muscle);
- a 60% higher risk of arrhythmia/cardiac arrest;
- a 61% higher risk of cardiomyopathy; and
- a 32% higher risk of new high blood pressure diagnosis.
Additionally, an analysis excluding those with high blood pressure during pregnancy (preeclampsia or gestational hypertension) found that individuals with prenatal depression had:
- an 85% higher risk for arrhythmia/cardiac arrest;
- an 84% higher risk of ischemic heart disease;
- a 42% higher risk of stroke;
- a 53% higher risk of cardiomyopathy; and
- a 43% higher risk of a new high blood pressure diagnosis.
Ackerman-Banks said, “Even after excluding those with hypertensive disorders of pregnancy, those with depression during pregnancy still had a significantly higher risk of ischemic heart disease, arrhythmia, stroke, cardiomyopathy, and new chronic hypertension postpartum.”
Cardiovascular disease is the leading cause of pregnancy-related death in high-income countries including the U.S., according to the American Heart Association’s 2023 Statistical Update. Additional pregnancy-related factors contributing to the development of cardiovascular disease may include chronic inflammation and increased stress-related hormones, the study authors noted.
“I recommend that anyone diagnosed with prenatal depression be aware of the implications on their long-term cardiovascular health, take steps to screen for other risk factors, and consult with their primary care doctor in order to implement prevention strategies for cardiovascular disease,” Ackerman-Banks said. “They should also be screened for Type 2 diabetes and high cholesterol, and implement an exercise regimen, healthy diet and quit smoking.”
The authors acknowledge that while the study population was large, the results were based on medical claims data, meaning that diagnoses of conditions could not be confirmed. Additionally, information on race, ethnicity, and physical activity levels were not available. Future studies testing interventions integrated into prenatal and postpartum care may help overcome these limitations and inform current recommendations, according to the study authors.
Reference: “Association of Depression and Poor Mental Health With Cardiovascular Disease and Suboptimal Cardiovascular Health Among Young Adults in the United States” by Yaa A. Kwapong, Ellen Boakye, Sadiya S. Khan, Michael C. Honigberg, Seth S. Martin, Chigolum P. Oyeka, Allison G. Hays, Pradeep Natarajan, Mamas A. Mamas, Roger S. Blumenthal, Michael J. Blaha and Garima Sharma, 23 January 2023, Journal of the American Heart Association.
DOI: 10.1161/JAHA.122.028332
The study was funded by the National Institutes of Health.
