Abstract P358: Association Between Psychological Distress and Cardiovascular Health Among Pregnant Individuals in the United States: Findings From Nationally Representative Data

Abstract

Background: Psychological health has an impact on pregnancy outcomes. The impact of psychological health during pregnancy on maternal cardiovascular health (CVH) is not well understood. Methods: Data from the US National Health Interview Survey (2013-2018) were used. All participants aged ≥18 years were included, excluding those with missing data for any of the exposure, outcome, or covariates. Psychological health was measured by the six-item Kessler scale (K6), and severe psychological distress (SPD) was defined as K6 ≥13. CVH was quantified based on the American Heart Association’s Life’s Essential 8 ; as detailed dietary data were unavailable, a seven-item CVH score was used (higher score indicated worse CVH). Multivariable Poisson regression was used to test associations between SPD and CVH, adjusting for the presence of any known cardiac condition, family income, education level, race, sex, sexual orientation, insurance coverage, and age. Results: Altogether, 1,111 participants were analyzed representing a weighted population of 1,576,091 persons. Worse psychological distress was independently associated with suboptimal cardiovascular health in pregnant individuals (adjusted risk ratio (aRR) 1.03 [95% confidence interval: 1.02, 1.04], p<0.001), with similar findings for SPD (aRR 1.34 [1.14, 1.58], p=0.001). These associations remained consistent regardless of age and race. Conclusions: Although SPD was relatively uncommon among pregnant individuals, it was strongly associated with worse maternal CVH. This underscores the critical need for a multidisciplinary approach that incorporates thorough psychological assessments in the care of pregnant individuals.