“Even after excluding those with hypertensive disorders of pregnancy” this risk factor could raise the possibility of developing heart disease by 83% following delivery.

Cardiovascular conditions have emerged as the primary contributor to pregnancy-associated fatalities in affluent nations, including the United States, as revealed in the American Heart Association’s 2023 Statistical Update.

Recent findings published in the Journal of the American Heart Association, a peer-reviewed, open access journal, indicate that expectant individuals diagnosed with depression exhibit a heightened likelihood of developing cardiovascular complications within a two-year span following childbirth, compared to those without a depression diagnosis.

The detrimental impact of depression on heart health among the general public is widely recognized: both men and women suffering from depression face an increased risk of developing cardiac issues as they age. Past studies have revealed that approximately one in five individuals undergo depression while expecting a child. Yet, there has been a lack of research focusing on prenatal depression as a distinct risk element for cardiovascular disease.

In this study, the researchers delved into the connection between prenatal depression and the onset of cardiovascular diseases within the first two years after childbirth. The investigative team utilized data provided by the Maine Health Data Organization’s All Payer Claims Database, encompassing over 100,000 individuals who had given birth in Maine from 2007 to 2019.

The study’s objective was to determine the cumulative risk of being diagnosed with new cardiovascular diseases within two years post-delivery. To ensure accuracy, researchers accounted for potential variables, including smoking habits, age at the time of delivery, pre-pregnancy diabetes, pre-pregnancy depression, pre-pregnancy hypertension, and preeclampsia. They then gauged the likelihood of developing six key cardiovascular conditions, namely heart failure, ischemic heart disease, arrhythmia/cardiac arrest, cardiomyopathy, stroke, and high blood pressure, all within two years following childbirth.

The findings revealed that those experiencing prenatal depression faced significantly elevated risks compared to their non-depressed counterparts. The results showed:

• A heightened risk of 83% for ischemic heart disease (problems stemming from constricted arteries providing blood to the heart muscle);
• A 60% increased likelihood of arrhythmia or cardiac arrest;
• A 61% greater risk of developing cardiomyopathy; and
• A 32% elevated chance of being diagnosed with high blood pressure

Moreover, an analysis that excluded participants with elevated blood pressure during pregnancy (such as preeclampsia or gestational hypertension) revealed that those experiencing antenatal depression faced:

• a surprising 85% increased likelihood of experiencing arrhythmia or cardiac arrest;
• an 84% heightened probability of developing ischemic heart disease;
• a 42% escalated risk of suffering a stroke;
• a 53% elevated chance of being diagnosed with cardiomyopathy; and
• a 43% increased potential for receiving a new high blood pressure diagnosis.

“Even after excluding those with hypertensive disorders of pregnancy,” comments lead study author Christina M. Ackerman-Banks, “those with depression during pregnancy still had a significantly higher risk of ischemic heart disease, arrythmia, stroke, cardiomyopathy and new chronic hypertension postpartum.”

The researchers also pointed out that factors linked to pregnancy, such as persistent inflammation and elevated stress hormones, could play a role in the emergence of cardiovascular disease.

Ackerman-Banks recommends “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.

“They should also be screened for Type 2 diabetes and high cholesterol, and implement an exercise regimen, healthy diet and quit smoking.”

The researchers admit that although their investigation involved a considerable number of participants, the findings relied on medical claims information, which prevents the verification of condition diagnoses. Furthermore, data on racial and ethnic backgrounds, as well as physical activity levels, were not accessible. The authors suggest that subsequent studies examining interventions incorporated into prenatal and postpartum care could address these shortcomings and contribute to refining existing guidelines.

Source: 10.1161/JAHA.122.028133

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