Abstract
BackgroundPreeclampsia involves endothelial dysfunction, platelet dysfunction/activation and sympathetic over-activity similar to cardiovascular disorders (CVD). Depression, an independent risk factor for progression of CVD, was found to be associated with an increased risk of preeclampsia among Finnish women. We examined the relation between depression/depressive symptoms and preeclampsia risk among Peruvian women.MethodsThe study included 339 preeclamptic cases and 337 normotensive controls. Depression and depressive symptoms during pregnancy were assessed using the Patient Health Questionnaire (PHQ-9). Odds ratios (OR) and 95% confidence intervals (CI) were estimated from logistic regression models.ResultsThe prevalence of moderate depression was 11.5% among cases and 5.3% among controls. The corresponding figures for moderate-severe depression were 3.5% for cases and 2.1% for controls. Compared with non-depressed women, those with moderate depression had a 2.3-fold increased risk of preeclampsia (95% CI: 1.2–4.4), while moderate-severe depression was associated with a 3.2-fold (95% CI: 1.1–9.6) increased risk of preeclampsia. Associations of each of the 9-items of the PHQ-9 depression screening module with preeclampsia risk were also observed.ConclusionOur findings are consistent with the only other published report on this topic. Collectively, available data support recent calls for expanded efforts to study and address depression among pregnant women.
Highlights
Preeclampsia involves endothelial dysfunction, platelet dysfunction/activation and sympathetic over-activity similar to cardiovascular disorders (CVD)
We explored the association between the frequency of experiencing each depressive symptom and preeclampsia risk
Compared with minimally depressed women, those with moderate depression during pregnancy had a 2.6-fold increased risk of preeclampsia (OR = 2.6; 95% confidence interval (CI): 1.4– 4.6)
Summary
Preeclampsia involves endothelial dysfunction, platelet dysfunction/activation and sympathetic over-activity similar to cardiovascular disorders (CVD). Depression, an independent risk factor for progression of CVD, was found to be associated with an increased risk of preeclampsia among Finnish women. The concept of a bio-behavioral model to explain the relationship between depression and CVD is gaining support in the literature [2,3]. Preeclampsia and CVD have overlapping risk factors, such as hypertension and diabetes, and appear to share similarities in pathophysiology, as both involve endothelial damage, vasoconstriction, platelet activation, and aggregation mediated by serotonin [5]. Taking into account the limited literature on this topic, we evaluated the relationship between maternal depression/depressive symptoms during pregnancy and preeclampsia risk, using data from a large case-control study of preeclampsia risk factors among Peruvian women
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