A comprehensive new scientific statement from the American Heart Association highlights the urgent need for integrating psychological health screening and treatment during and after pregnancy to reduce adverse health outcomes and improve maternal cardiovascular health.
The statement underscores the complex relationship between mental health and cardiovascular risk, revealing that psychological conditions such as depression and anxiety are among the leading causes of maternal mortality in the United States. With an estimated 52% of women of reproductive age reporting a history of psychological health conditions, the research calls for a holistic approach to maternal healthcare.
Cardiovascular issues remain the primary cause of maternal death, with significant disparities evident across racial and ethnic groups. Non-Hispanic Black birthing women experience mortality rates 2.6 times higher than non-Hispanic white women, emphasizing the critical need for targeted interventions.
Dr. Garima Sharma, the statement's chair, stressed the importance of redefining maternal cardiovascular health to include psychological well-being. The research suggests that psychological health encompasses emotional, social, and functional aspects of life, significantly influenced by factors such as living conditions, traumatic events, and daily stressors.
The statement recommends routine screening using tools like the Patient Health Questionnaire (PHQ-9) and advocates for a multidisciplinary approach involving healthcare professionals from various specialties. Screening should be comprehensive, culturally responsive, and conducted throughout pregnancy and the postpartum period.
Risk factors for psychological concerns include domestic violence, sleep disorders, personal or family mental health history, lack of partner support, unemployment, and experiences of racism and discrimination. The research emphasizes that identifying and addressing these modifiable risk factors can improve both maternal psychological and cardiovascular health.
While pharmacological treatments are an option, the statement also highlights the potential of non-pharmaceutical interventions such as counseling, cognitive behavioral therapies, exercise, and stress management strategies.
The research identifies significant barriers to implementing comprehensive mental health care, including stigma, clinician time constraints, and systemic challenges. Future research needs include expanding studies to include more diverse populations and exploring psychological factors beyond depression.
By integrating mental health screening into routine maternal care, healthcare providers can potentially mitigate long-term cardiovascular risks and improve overall maternal health outcomes across diverse populations.
