Women who experience depression during pregnancy or after birth appear to have a higher risk of cardiovascular disease

Women diagnosed with perinatal depression are more likely to develop cardiovascular disease over the next 20 years compared to women who gave birth without experiencing perinatal depression, according to research published in the European Heart Journal.

It is believed that perinatal depression, that is, depression during pregnancy or after birth, affects one in five women who give birth worldwide.

The study is the first of its kind to look at cardiovascular health after perinatal depression and included data from approximately 600,000 women. It found the strongest links with risks of high blood pressure, ischemic heart disease and heart failure.

The research was conducted by Dr. Emma Brann, Dr. Donghao Lu and colleagues from the Karolinska Institutet, Stockholm, Sweden.

Dr. Lu said: “Our research group has already found that perinatal depression is linked to an increased risk of several other health problems, including premenstrual disorders, autoimmune diseases and suicidal behavior, as well as premature death. Cardiovascular diseases are one of the most important diseases. causes of death worldwide and there is an ongoing discussion about including reproductive health when assessing risk in women. We wanted to know whether a history of perinatal depression could help predict the risk of cardiovascular disease.

The study was based on the Swedish Medical Birth Register, which records all births in the country. The researchers compared 55,539 Swedish women who were diagnosed with perinatal depression between 2001 and 2014 with another group of 545,567 Swedish women who had also given birth during that time but were not diagnosed with perinatal depression. All women were followed until 2020 to assess whether they developed cardiovascular disease.

Of women with perinatal depression, 6.4% developed cardiovascular disease, compared with 3.7% of women who had not had perinatal depression. This corresponds to a 36% higher risk of developing cardiovascular disease. Their risk of high blood pressure was about 50% higher, the risk of ischemic heart disease about 37% higher and the risk of heart failure about 36% higher.

Dr. Bränn, the senior author, said: “Our findings may help identify people who are at higher risk of cardiovascular disease so that steps can be taken to reduce this risk. This study also adds to the identified health risks of perinatal depression. We know that perinatal depression is both preventable and treatable, and for many people this is the first episode of depression they have ever experienced. Our findings provide more reasons to ensure maternal care is holistic, with equal attention to both physical and mental health.

“It remains unclear how and through which pathways perinatal depression leads to cardiovascular disease. We need to do more research to understand this so we can find the best ways to prevent depression and lower your risk of cardiovascular disease.

Researchers also compared the women suffering from perinatal depression with their sisters and found that they had a 20% higher risk of cardiovascular disease.

“The slightly lower risk difference between sisters suggests that genetic or familial factors may be partly involved,” said Dr. Brann. “Other factors may also be involved, as is the case for the link between other forms of depression and cardiovascular disease. These include changes in the immune system, oxidative stress and lifestyle changes that have been implicated in major depression.”

In an accompanying editorial, Dr. Amani Meaidi of the Danish Cancer Society: Kraeftens Bekaempelse, Copenhagen, Denmark: “Although signs of postpartum mood disorders have been noted since the time of Hippocrates, it was only last year, in 2023, that the US Food and Drug Administration announced the first approved oral treatment for postpartum depression, making the treatment much more accessible to the millions of women who suffer from this condition.

“The late and inadequate development of effective, safe, and accessible treatment options for perinatal depression is unequivocally a manifestation of the historical neglect of women’s health in medical research. The future will show whether proper treatment of perinatal depression reduces the observed increased risk of developing depression.” cardiovascular morbidity.

“Given the increase in perinatal depression and the lack of knowledge about cardiovascular disease in women, Bränn and colleagues’ research is much needed and welcome.”