Postpartum Depression Increases the Risk of Cardiovascular Events: EHJ

A recent study published in the European Heart Journal highlighted the significant health risks associated with maternal postpartum depression which approximately affects 17% of birthing women annually. The study by Amani Meaidi and colleagues revealed a strong connection between perinatal depression and an increased risk of developing various cardiovascular diseases which underlines the urgent need for comprehensive care and monitoring of affected women.

Despite progress in understanding its psychological impacts, the somatic health consequences of postpartum depression remain less explored. This comprehensive study was set out to bridge this gap by investigating the association between perinatal depression and subsequent cardiovascular morbidity. This nationwide observational matched cohort study in Sweden included a total of 55,539 women diagnosed with perinatal depression between 2001 and 2014, matched with 545,567 unaffected women. The participants were followed up until 2020 to monitor the development of cardiovascular diseases.

The outcomes of this study found that women with a history of perinatal depression showed an elevated risk of developing hypertension, ischemic heart disease, heart failure, thromboembolism, and arrhythmias when compared to their unaffected counterparts. Also, 6.4% of women with perinatal depression underwent incident cardiovascular diseases during the follow-up period when compared to 3.7% among unaffected women. This translates to a 36% higher adjusted risk of cardiovascular disease in women with perinatal depression that has persisted for over a decade after the initial diagnosis.

Further analysis through sibling comparisons revealed that the increased cardiovascular risk remained significant, although somewhat attenuated, even when genetic and familial environmental factors were considered. This suggests a robust link between perinatal depression and cardiovascular morbidity beyond shared family characteristics.

Also, the study controlled for several known cardiovascular risk factors, including body mass index and smoking. It confirmed the association between perinatal depression and cardiovascular disease in subcohorts of women without other psychiatric disorders or adverse pregnancy outcomes that reinforces the likelihood of a causal relationship.

The observed risk of cardiovascular disease associated with perinatal depression is similar to that linked with any other form of depression. This underlines the importance of detecting and treating all forms of depression in women, not just the women diagnosed perinatally. Depression and cardiovascular disease share common genetic and pathogenic components like inflammation, which may explain the increased cardiovascular risk observed in this study.

As perinatal depression rates steadily rise, the understanding of cardiovascular disease in women remains incomplete. And so, the findings of this study provide the much-needed insight. Future research will determine whether proper therapy for perinatal depression can reduce the increased cardiovascular risk observed in this study by potentially improving long-term health outcomes for millions of women throughout the globe.

Source:

Meaidi, A. (2024). Perinatal depression and incident maternal cardiovascular disease: a neglected association. In European Heart Journal. Oxford University Press (OUP). https://doi.org/10.1093/eurheartj/ehae340