Prenatal depression tied to new CVD after childbirth
Click Here to Manage Email Alerts
Key takeaways:
- Women with prenatal depression are more likely to develop new CVD after delivery.
- The observed association was strongest for ischemic heart disease.
Pregnant people with a diagnosis of prenatal depression are more likely to be diagnosed with new CVD in the 24 months after delivery, even without co-occurring hypertensive disorders of pregnancy, researchers reported.
“We need to use pregnancy as a window to future health,” Christina M. Ackerman-Banks, MD, assistant professor of obstetrics and gynecology-maternal fetal medicine at Baylor College of Medicine and Texas Children’s Hospital in Houston, said in a press release. “Complications during pregnancy, including prenatal depression, impact long-term cardiovascular health. The postpartum period provides an opportunity to counsel and screen people for CVD in order to prevent these outcomes.”
Data were derived from Ackerman-Banks CM, et al. J Am Heart Assoc. 2023;doi:10.1161/JAHA.122.028133.
In a longitudinal, population-based study, Ackerman-Banks and colleagues analyzed data from 119,422 pregnant people with deliveries between 2007 and 2019, using the Maine Health Data Organization’s All Payer Claims Data. Patients with prepregnancy CVD, multifetal gestations or no continuous health insurance during pregnancy were excluded. Researchers assessed associations between prenatal depression and CVD, including HF, ischemic heart disease, arrhythmia/cardiac arrest, cardiomyopathy, cerebrovascular disease, and chronic hypertension, with analyses stratified by hypertensive disorder of pregnancy status.
The findings were published in the Journal of the American Heart Association.
Within the cohort, the prevalence of prenatal depression was 21.6%. The cumulative risks for new diagnoses for CVD in the first 24 months postpartum were 0.2% for HF, ischemic heart disease, cardiomyopathy, and arrhythmia, 0.5% for stroke and 2.1% for hypertension. The cumulative risk for severe cardiac disease, a composite of HF, stroke or cardiomyopathy, was 0.8%.
Researchers found that pregnant people with prenatal depression had an increased risk for ischemic heart disease (adjusted HR = 1.83; 95% CI, 1.2-2.8), as well as arrhythmia/cardiac arrest (aHR = 1.6; 95% CI, 1.1-2.31), cardiomyopathy (aHR = 1.61; 95% CI, 1.15-2.24), and new hypertension (aHR = 1.32; 95% CI, 1.17-1.5).
In analyses stratified by co-occurring hypertensive disorders of pregnancy, several associations persisted.
The researchers also noted that associations between prenatal depression and some CVD outcomes were attenuated after adjusting for anxiety during pregnancy, suggesting that prenatal depression alone may not increase the risk for these CVD diagnoses.
“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 in the release. “They should also be screened for type 2 diabetes and high cholesterol and implement an exercise regimen, healthy diet and quit smoking.”
Reference:
- Prenatal depression may be linked to cardiovascular disease after childbirth. https://newsroom.heart.org/news/prenatal-depression-may-be-linked-to-cardiovascular-disease-after-childbirth. Published on April 19, 2023. Accessed on April 19, 2023.
Collapse
Click Here to Manage Email Alerts