Research Highlights:

  • 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.

 

Newswise — DALLAS, April 19, 2023 —

New research published today in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association, indicates that individuals diagnosed with depression during pregnancy were more likely to be diagnosed with cardiovascular disease within two years after giving birth than those without depression.

The adverse impacts of depression on cardiovascular well-being among the overall populace are thoroughly established: males and females suffering from depression are more prone to developing heart ailments in the future, and earlier investigations have shown that roughly 20% of people undergo depression while pregnant. Nevertheless, inadequate research has been carried out on antenatal depression as a distinct risk element for cardiovascular illness.

"Our focus should be on leveraging pregnancy as a gateway to forthcoming well-being," expressed the principal investigator Christina M. Ackerman-Banks, M.D., who holds the position of an assistant professor in obstetrics and gynecology-maternal fetal medicine at Baylor College of Medicine and Texas Children's Hospital situated in Houston. "Complications that arise during pregnancy, such as antenatal depression, have a long-lasting impact on cardiovascular fitness. The phase following childbirth presents a chance to offer guidance and carry out screening measures for cardiovascular ailments to avoid such repercussions."

This investigation is the initial populace-based research that centers mainly on exploring the correlation between antenatal depression and cardiovascular disease diagnosis in the postpartum stage during the first two years after delivery. The team of researchers examined information obtained from the Maine Health Data Organization's All Payer Claims Database, covering more than 100,000 individuals who gave birth in Maine from 2007 to 2019. The primary objective of the researchers was to gauge the collective probability of fresh cardiovascular disease diagnoses within two years following childbirth.

The research team made adjustments for potential factors that could skew the results, including smoking, age at the time of delivery, pre-pregnancy diabetes, pre-pregnancy depression, pre-pregnancy hypertension, and preeclampsia. Subsequently, the researchers approximated the probability of developing six significant cardiovascular diseases, namely, heart failure, ischemic heart disease, arrhythmia/cardiac arrest, cardiomyopathy, stroke, and high blood pressure, within two years of childbirth.

The assessment discovered that the predicted collective risk of cardiovascular diseases, such as heart failure, ischemic heart disease, cardiomyopathy, arrhythmia/cardiac arrest, or newly diagnosed high blood pressure, within two years following childbirth, was substantially greater for individuals with depression in comparison to those lacking depression. Expectant mothers with depression experienced:

 

  • 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.

As per Ackerman-Banks, "Despite eliminating individuals with hypertensive pregnancy conditions, those experiencing depression during pregnancy still encountered notably greater risk of ischemic heart disease, arrhythmia, stroke, cardiomyopathy, and newly developed persistent hypertension following childbirth."

According to the American Heart Association's 2023 Statistical Update, cardiovascular disease is the primary cause of maternal deaths related to pregnancy in high-income countries, including the U.S. The study authors pointed out that other pregnancy-related elements that may lead to the onset of cardiovascular disease could encompass chronic inflammation and elevated stress-associated hormones.

Ackerman-Banks suggested that individuals diagnosed with prenatal depression should be mindful of its impact on their cardiovascular health in the long run. Furthermore, they should undertake measures to screen for other potential risk factors and consult their primary care physician to implement preventive measures against cardiovascular disease. It is also advisable to undergo screening for Type 2 diabetes and high cholesterol, initiate an exercise routine, adopt a healthy diet, and quit smoking.

The authors of the study recognized that although the sample size was substantial, the findings relied on medical claims data, indicating that diagnosis of medical conditions could not be authenticated. Additionally, details pertaining to race, ethnicity, and physical activity levels were unavailable. The study authors recommend that future research exploring interventions incorporated into prenatal and postpartum care could potentially address these limitations and provide insights into current recommendations.

Heather S. Lipkind, M.D., M.S.; Kristin Palmsten, Sc.D.; Mariah Pfeiffer, R.N., M.P.H.; Catherine Gelsinger, R.N.; and Katherine A. Ahrens, M.P.H., Ph.D., are co-authors of the study. Disclosures of the authors are outlined in the manuscript.

The study was funded by the National Institutes of Health.

The American Heart Association (AHA) states that the statements and conclusions of studies published in its scientific journals represent the views of the study authors and do not necessarily reflect the AHA's policy or position. The AHA does not guarantee the accuracy or reliability of these statements and conclusions. The organization receives funding from individuals, foundations, and corporations, including pharmaceutical, device manufacturers, and other companies, which also support specific AHA programs and events. However, the AHA has strict policies to ensure that these relationships do not influence the scientific content. Information on the AHA's overall financial status and its relationships with pharmaceutical and biotech companies, device manufacturers, and health insurance providers are available on its website.

Additional Resources:

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations, and powered by millions of volunteers, we fund innovative research, advocate for the public’s health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.

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Journal Link: Journal of the American Heart Association

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CITATIONS

Journal of the American Heart Association

TYPE OF ARTICLE
Research Results
SECTION
CHANNELS
All Journal News Cardiovascular Health Heart Disease OBGYN Psychology and Psychiatry Women's Health
KEYWORDS
Prenatal depression Childbirth Cardiovascular Disease
COMMENTS | COMMENTING POLICY