Pregnancy blues may lead to heart problems postpartum

Women with prenatal depression appears to have an elevated cumulative risk of developing cardiovascular disease (CVD) within 24 months postpartum, with the risk persisting despite the absence of co‐occurring hypertensive disorders of pregnancy, as reported in a study.

For this longitudinal population‐based study, researchers used the Maine Health Data Organization's All Payer Claims Data and looked at pregnant individuals who delivered during 2007 to 2019. Exclusion criteria were prepregnancy CVD, multifetal gestations, or no continuous health insurance during pregnancy.

The association between prenatal depression and CVD (heart failure, ischaemic heart disease, arrhythmia/cardiac arrest, cardiomyopathy, cerebrovascular disease, and chronic hypertension) was estimated using multivariable Cox models, stratified by hypertensive disorder of pregnancy.

A total of 119,422 pregnancies were included in the analysis. The prevalence of prenatal depression was 21.6 percent, and the overall cumulative risk of postpartum depression was 29.0 percent. Baseline characteristics were similar between the groups of women with and without prenatal depression, with the exception that some characteristics were more commonly observed in the prenatal depression group, such as use of Medicaid insurance and prepregnancy depression and anxiety.

Prenatal depression was associated with an increased risk of ischaemic heart disease (adjusted HR [aHR], 1.83, 95 percent confidence interval [CI], 1.20–2.80), arrhythmia/cardiac arrest (aHR, 1.60, 95 percent CI, 1.10–2.31), cardiomyopathy (aHR, 1.61, 95 percent CI, 1.15–2.24), and new hypertension (aHR, 1.32, 95 percent CI, 1.17–1.50).

Several of the observed associations between prenatal depression and CVD risks persisted even for pregnancies without co‐occurring hypertensive disorders of pregnancy.

The findings highlight the importance of reviewing an individual’s pregnancy‐specific risk factors, including prenatal depression, when screening for postpartum CVD.