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Published on: June 13, 2021
Optimizing Psychological Health Across the Perinatal Period: An Update on Maternal Cardiovascular Health: A
Insights
Perinatal psychological health conditions significantly impact maternal mortality and offspring development. Integrating psychological care into maternal cardiovascular health is vital for improved outcomes.
Area of Science:
- Cardiology
- Psychiatry
- Public Health
Background:
- Perinatal psychological health conditions are leading causes of maternal mortality.
- These conditions are linked to adverse pregnancy and long-term cardiovascular outcomes.
- Intergenerational effects on offspring neurodevelopment are also associated with perinatal psychological health issues.
Purpose of the Study:
- To redefine maternal cardiovascular health to encompass psychological health.
- To provide evidence on the association between psychological health and cardiovascular outcomes.
- To offer guidance on integrating psychological health into maternal cardiovascular care during the perinatal period.
Main Methods:
- Review of evidence linking psychological health to cardiovascular outcomes.
- Highlighting social and environmental factors influencing perinatal psychological health.
- Proposing integrated care delivery models for cardio-obstetric care.
Main Results:
- Maternal psychological health is a critical determinant of perinatal cardiovascular health.
- Integration of psychological care can improve maternal and offspring outcomes.
- New care models emphasize recurrent screening, longer follow-up, and intervention.
Conclusions:
- Maternal cardiovascular health must include psychological health.
- Integrated psychological and cardiovascular care is essential during the perinatal period.
- Further research on comparative effectiveness of care models is needed.
Abstract:
Perinatal psychological health conditions (eg, perinatal depression, anxiety) are some of the leading causes of maternal mortality in the United States and are associated with adverse pregnancy outcomes, long-term cardiovascular outcomes, and intergenerational effects on offspring neurodevelopment. These risks underscore the importance of addressing maternal psychological health as a key determinant of perinatal cardiovascular health. Thus, it is vital to recognize the spectrum of perinatal psychological health and to provide guidance for both patients and clinicians on screening and management options across the perinatal period. In this scientific statement from the American Heart Association, we redefine maternal cardiovascular health to include psychological health, provide robust evidence on the association of psychological health with cardiovascular outcomes, highlight the social and environmental underpinnings, and finally, offer guidance about how to integrate psychological health into maternal cardiovascular health with a specific focus on the perinatal period (ie, pregnancy through 1 year postpartum). We also describe opportunities for creating care delivery models that recurrently address perinatal psychological health in cardio-obstetric care, using behavioral and pharmacological interventions, with an emphasis on better integration of psychological health care, longer postpartum follow-up, and opportunities for evaluating the comparative effectiveness of these models with stakeholder partners.
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