Individuals who were diagnosed with depression while pregnant were more more likely to be diagnosed with heart problems inside two years after giving birth than individuals without depression, in keeping with recent research published today within the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association.

The negative effects of depression on cardiovascular health in the final population are well established: depressed men and girls usually tend to develop heart disease later in life, and former research has found that about 20% of people experience depression while pregnant. Nonetheless, little research has been done on prenatal depression as a selected risk factor for heart problems.

We’d like to make use of pregnancy as a window to future health. Complications while pregnant, including prenatal depression, impact long-term cardiovascular health. The postpartum period provides a possibility to counsel and screen people for heart problems with a view to prevent these outcomes.”

Christina M. Ackerman-Banks, M.D., lead study creator, assistant professor of obstetrics and gynecology-maternal fetal medicine at Baylor College of Medicine and Texas Kid’s Hospital in Houston

This study is the primary population-based study to primarily investigate the connection between prenatal depression and postpartum heart problems diagnosis throughout 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 latest heart problems diagnoses inside two years after delivery.

After adjusting for potential confounding aspects akin to smoking, age at time of delivery and pre-pregnancy diabetes, pre-pregnancy depression, pre-pregnancy hypertension and preeclampsia, the researchers estimated the danger of developing six major cardiovascular conditions -; heart failure, ischemic heart disease, arrhythmia/cardiac arrest, cardiomyopathy, stroke and hypertension -; inside two years of delivery.

The evaluation found that the estimated cumulative heart problems risk for heart failure, ischemic heart disease, cardiomyopathy, arrhythmia/cardiac arrest or newly diagnosed hypertension inside two years of delivery was significantly higher for individuals with depression in comparison with the people without depression. Individuals with prenatal depression had:

• an 83% higher risk of ischemic heart disease (issues attributable to narrowed heart arteries supplying blood to the guts muscle);
• a 60% higher risk of arrhythmia/cardiac arrest;
• a 61% higher risk of cardiomyopathy; and
• a 32% higher risk of latest hypertension diagnosis.

Moreover, an evaluation excluding those with hypertension while pregnant (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 recent hypertension diagnosis.

Ackerman-Banks said, “Even after excluding those with hypertensive disorders of pregnancy, those with depression while pregnant still had a significantly higher risk of ischemic heart disease, arrythmia, stroke, cardiomyopathy and recent chronic hypertension postpartum.”

Heart problems is the leading reason behind pregnancy-related death in high-income countries including the U.S., in keeping with the American Heart Association’s 2023 Statistical Update. Additional pregnancy-related aspects contributing to the event of heart problems may include chronic inflammation and increased stress-related hormones, the study authors noted.

“I like to recommend that anyone diagnosed with prenatal depression concentrate on the implications on their long-term cardiovascular health, take steps to screen for other risk aspects and seek the advice of with their primary care doctor with a view to implement prevention strategies for heart problems,” Ackerman-Banks said. “They also needs to be screened for Type 2 diabetes and high cholesterol, and implement an exercise regimen, healthy food plan and quit smoking.”

The authors acknowledge that while the study population was large, the outcomes were based on medical claims data, meaning that diagnoses of conditions couldn’t be confirmed. Moreover, information on race, ethnicity and physical activity levels weren’t available. Future studies testing interventions integrated into prenatal and postpartum care may help overcome these limitations and inform current recommendations, in keeping with the study authors.

Source:

American Heart Association

Journal reference:

Ackerman‐Banks, C. M., et al. (2023) Association of Prenatal Depression With Latest Cardiovascular Disease Inside 24 Months Postpartum. Journal of the American Heart Association. doi.org/10.1161/JAHA.122.028133.