Perinatal depression may raise heart disease risk in women

Women diagnosed with perinatal depression — meaning depression during pregnancy or after childbirth — are more likely to develop cardiovascular disease within 20 years compared to women who have given birth without experiencing perinatal depression, according to new research published in the European Heart Journal.

Led by Dr Emma Bränn, Dr Donghao Lu and their colleagues at Sweden’s Karolinska Institutet, the new study is the first of its kind to look at cardiovascular health after perinatal depression. It was based on the Swedish Medical Birth Register, which records all births in the country.

“Our research group has already found that perinatal depression is linked to an increased risk of several other health issues, including premenstrual disorders, autoimmune disorders and suicidal behaviour, as well as premature death,” Lu said.

“Cardiovascular disease is one of the leading causes of death globally and there has been an ongoing discussion about including reproductive health when assessing the risk among women. We wanted to know if a history of perinatal depression could help predict cardiovascular disease risk.”

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 the women were followed up through to 2020 to assess if they developed any cardiovascular disease.

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

The researchers also compared the women who suffered perinatal depression with their sisters and found they had a 20% higher risk of cardiovascular disease. According to Bränn, “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.”

Bränn concluded that the team’s findings add to the established health risks of perinatal depression, and may help to identify people who are at a higher risk of cardiovascular disease so that steps can be taken to reduce this risk.

“It remains unclear how and through what pathways perinatal depression leads to cardiovascular disease,” Bränn acknowledged. “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.”

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