Risk of Cardiovascular Events During Delivery Hospitalization Among Pregnant Patients With Mental Health Conditions

Area of Science:

• Obstetrics and Gynecology
• Cardiology
• Psychiatry

Background:

• Cardiovascular disease is the primary cause of maternal mortality.
• The link between mental health disorders and cardiovascular disease in pregnant individuals is not well understood.
• Mental health conditions are known risk factors for cardiovascular disease in nonpregnant populations.

Purpose of the Study:

• To investigate the association between mental health conditions and cardiovascular outcomes during delivery hospitalizations.
• To determine if mental health diagnoses increase the risk of severe maternal morbidity and mortality (SMM) or other cardiovascular complications.

Main Methods:

• Cross-sectional study utilizing 2021 National Inpatient Sample delivery hospitalization data.
• Generalized estimating equations with quasi-Poisson regression models were used to analyze cardiovascular SMM and non-SMM events.
• Incidence rate ratios were calculated for various mental health conditions, adjusted for clinical, social, and pregnancy characteristics.

Main Results:

• 12.4% of 667,902 delivery hospitalizations included a mental health diagnosis.
• Patients with mental health conditions had significantly higher adjusted rates of cardiovascular SMM (aIRR, 2.36) and other cardiovascular complications (aIRR, 1.94).
• Depression, anxiety, and posttraumatic stress disorder were individually associated with increased cardiovascular risks.

Conclusions:

• Mental health conditions are potential risk factors for adverse cardiovascular events during delivery.
• Further research is needed to elucidate the physiological mechanisms underlying this association.
• Identifying and managing mental health conditions may be crucial for preventing cardiovascular complications in pregnant patients.