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Women with perinatal depression at increased risk of cardiovascular disease, study finds

Women who experience perinatal depression have an increased risk of developing cardiovascular disease, a study has found.

Researchers from the Karolinska Institutet in Sweden suggested that a history of perinatal depression could help predict cardiovascular disease.

Women who experience perinatal depression were found to have a 36% higher risk of developing cardiovascular disease and are more likely to develop high blood pressure, ischemic heart disease and heart failure in the 20 years after birth compared to women who have given birth without experiencing the condition.

The findings, published in the European Heart Journal, may help identify people at a higher risk of cardiovascular disease so that preventative measures can be taken to reduce the risk, the researchers said.

Perinatal depression can be experienced during or after pregnancy and is thought to affect one in five women who give birth worldwide. While major (non-perinatal) depression has consistently been associated with cardiovascular disease in previous studies, the long-term risk after perinatal depression is unknown.

Using data from the Swedish Medical Birth Register, the researchers analysed data from over 600,000 women who had given birth between 2001 and 2014. Of the women studied, 55,539 had been diagnosed with perinatal depression. All the women were followed up through to 2020 and assessed for cardiovascular disease.

The researchers found that women with perinatal depression were at a greater risk of developing heart disease, particularly high blood pressure, ischemic heart disease and heart failure.

Among the women with perinatal depression, 6.4% developed cardiovascular disease compared to 3.7% of women who had not suffered from it. Their risk of high blood pressure was around 50%, the risk of ischemic heart disease around 37%, and the risk of heart failure around 36% higher.

Dr Emma Bränn PhD, a postdoctoral researcher at the Karolinska Institute in Sweden, said: ‘This study adds to the established health risks of perinatal depression. Our findings provide more reason for ensuring maternal care is holistic, with equal attention on both physical and mental health.’

The researchers said it was unclear how perinatal depression leads to cardiovascular disease. Analysis of the sisters of women with the condition highlighted that they had a 20% higher risk of cardiac disease, suggesting there may be a genetic component to the findings.

Dr Bränn explained: ‘The slightly lower difference in risk between sisters suggests that there could be genetic or familial factors partly involved. There could also be other factors involved, as is the case for the link between other forms of depression and cardiovascular disease. These include alterations in the immune system, oxidative stress and lifestyle changes implicated in major depression.’

She added: ‘We need to do more research to understand this so that we can find the best ways to prevent depression and lower the risk of cardiovascular disease.’

A version of this article was originally published by our sister publication Nursing in Practice.