Pregnant women with depression may face higher heart disease, stroke risk after delivery

By American Heart Association News

Ekaterina Goncharova/Moment via Getty Images
(Ekaterina Goncharova/Moment via Getty Images)

Women who experience depression during pregnancy are more likely than those who don't to be diagnosed with cardiovascular disease within two years of giving birth, new research suggests.

The study, published Wednesday in the Journal of the American Heart Association, adds to a body of research linking depression in men and women to cardiovascular disease later in life.

"We need to use pregnancy as a window to future health," lead study author Dr. Christina M. Ackerman-Banks said in a news release. Banks is an assistant professor of obstetrics and gynecology-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."

About 1 in 5 women experience depression during pregnancy, according to previous research that was confirmed in the new study. However, not much is known about the potential links between prenatal depression and cardiovascular disease.

Researchers analyzed medical claims data for about 120,000 women who gave birth in Maine between 2007 and 2019. After adjusting for factors such as pre-pregnancy depression, high blood pressure and diabetes, researchers estimated the risk within two years of delivery for six cardiovascular conditions: heart failure, ischemic heart disease, arrhythmia/cardiac arrest, cardiomyopathy, stroke and high blood pressure.

For women diagnosed with depression during pregnancy, the analysis found:

– an 83% higher risk of ischemic heart disease, a condition caused by narrowed heart arteries;

– a 61% higher risk of cardiomyopathy;

– a 60% higher risk of arrhythmia/cardiac arrest;

– a 32% higher risk of a new high blood pressure diagnosis; and

– a 27% higher risk of stroke.

Even after researchers excluded women who developed high blood pressure during pregnancy, those with depression during pregnancy still had a significantly higher risk within two years:

– an 85% greater risk of arrhythmia/cardiac arrest;

– an 84% greater risk of ischemic heart disease;

– a 53% greater risk of cardiomyopathy;

– a 43% greater risk of a new high blood pressure diagnosis; and

– a 42% greater risk of stroke.

The study showed that the overall percentage of women who developed one of these conditions was low. Even so, cardiovascular disease is the leading cause of pregnancy-related deaths in the U.S. and other high-income countries, according to American Heart Association statistics. Chronic inflammation and increased stress-related hormones also may contribute to the higher rates of post-pregnancy cardiovascular illness, the researchers said.

"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."

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