RAND Pittsburgh PA.
Department of Psychology University of Pittsburgh Pittsburgh PA.
J Am Heart Assoc. 2024 Jun 18;13(12):e034153. doi: 10.1161/JAHA.123.034153. Epub 2024 Jun 14.
Adverse cardiovascular events during pregnancy (eg, preeclampsia) occur at higher rates among individuals with overweight or obesity (body mass index ≥25 kg/m) and have been associated with postpartum depression. The present study examined whether changes in cardiovascular health (CVH) during the perinatal period, as defined by the American Heart Association's Life's Essential 8 framework, predicted postpartum psychological functioning among individuals with prepregnancy body mass index ≥25 kg/m.
Pregnant individuals (N = 226; mean ± SD age = 28.43 ± 5.4 years; mean body mass index = 34.17 ± 7.15 kg/m) were recruited at 12 to 20 weeks of gestation (mean, 15.64 ± 2.45 weeks) for a longitudinal study of health and well-being. Participants completed ratings of depression and perceived stress and reported on CVH behaviors (dietary intake, physical activity, nicotine exposure, and sleep) at baseline and at 6 months postpartum. Body mass index and CVH behaviors were used to calculate a composite CVH score at both time points. Linear regression analyses were performed to examine whether change in CVH related to postpartum symptom scores. Because sleep was measured in only a subset of participants (n = 114), analyses were conducted with and without sleep. Improved CVH was associated with lower postpartum depression (β = -0.18, <0.01) and perceived stress (β = -0.13, =0.02) scores. However, when including sleep, these relationships were no longer significant (all >0.4).
Improvements in CVH from early pregnancy to 6 months postpartum were associated with lower postpartum depressive symptoms and perceived stress but not when including sleep in the CVH metric, potentially due to the large reduction in sample size. These data suggest that intervening during pregnancy to promote CVH may improve postpartum psychological functioning among high-risk individuals.
超重或肥胖（体重指数≥25kg/m²）的个体在怀孕期间发生不良心血管事件（如子痫前期）的风险较高，并且与产后抑郁症有关。本研究旨在探讨在妊娠期间心血管健康（CVH）的变化（通过美国心脏协会的“生命的八项要素”框架定义）是否可以预测孕前体重指数≥25kg/m²的个体的产后心理功能。
在妊娠 12 至 20 周（平均 15.64±2.45 周）时，招募了 226 名孕妇（平均年龄 28.43±5.4 岁，平均体重指数 34.17±7.15kg/m²）进行健康和幸福感的纵向研究。参与者在基线和产后 6 个月时完成了抑郁和感知压力的评分，并报告了 CVH 行为（饮食摄入、体力活动、尼古丁暴露和睡眠）。使用体重指数和 CVH 行为在两个时间点计算复合 CVH 评分。进行线性回归分析以检查 CVH 变化与产后症状评分的关系。由于仅对一部分参与者（n=114）进行了睡眠测量，因此进行了包含和不包含睡眠的分析。CVH 的改善与产后抑郁（β=-0.18，<0.01）和感知压力（β=-0.13，=0.02）评分降低相关。然而，当将睡眠纳入 CVH 指标时，这些关系不再显著（均>0.4）。
从孕早期到产后 6 个月，CVH 的改善与产后抑郁症状和感知压力降低相关，但当将睡眠纳入 CVH 指标时则不相关，这可能是由于样本量大幅减少所致。这些数据表明，在妊娠期间干预以促进 CVH 可能会改善高危个体的产后心理功能。
