Cardiovascular disease during childbirth might be associated to pre-natal depression: Study

A new research from the American Heart Association, stated that women who were diagnosed with depression during pregnancy had a higher risk of being detected with cardiovascular disease within two years of giving birth compared to women who did not have depression.

According to new research published today in the Journal of the American Heart Association, It is well known that depression has a detrimental impact on cardiovascular health in the general population. Both men and women who experience depression are more likely to develop heart disease in later life, and previous studies have shown that about 20% of pregnant women also experience depression. Prenatal depression has received little attention as a particular risk factor for cardiovascular disease, though.”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 gynaecology-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.”

The association between prenatal depression and the detection of postpartum cardiovascular disease during the first two years following delivery is the focus of this investigation, which is the first population-based study to do so. Almost 100,000 women who gave birth in Maine between 2007 and 2019 were the subject of data analysis from the All-Payer Claims Database of the Maine Health Data Organization. The study aimed to calculate the overall risk of receiving a new cardiovascular disease diagnosis within two years following birth.

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 than those without depression.

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 the 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 was 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.