TY - JOUR
T1 - Psychological Distress and Cardiovascular Health in Pregnancy
T2 - Findings From the U.S. National Health Interview Survey
AU - Satti, Danish Iltaf
AU - Chan, Jeffrey Shi Kai
AU - Metlock, Faith E.
AU - Mszar, Reed
AU - Mehta, Adhya
AU - Chan, Raymond Ngai Chiu
AU - Chang, Ryan
AU - Spitz, Jared
AU - Saad, Antonio
AU - Gaffey, Allison E.
AU - Javed, Zulqarnain
AU - Dastmalchi, Lily Nedda
AU - Mehta, Anurag
AU - Powell-Wiley, Tiffany
AU - Sharma, Garima
N1 - Publisher Copyright:
© 2025 The Authors
PY - 2025/5
Y1 - 2025/5
N2 - Background: The relationship between psychological health and cardiovascular health (CVH) during pregnancy is not well characterized. Objectives: The purpose of this study was to perform a cross-sectional analysis in order to assess the relationships between psychological distress and CVH among pregnant individuals in the United States. Methods: U.S. National Health Interview Survey (2013-2018) data were used for the analyses. The sample included all pregnant participants aged ≥18 years, but excluded those with missing data for the exposure, outcome, or covariates. Psychological health was measured with the 6-item Kessler scale, and severe psychological distress was defined as 6-item Kessler scale ≥13. CVH was quantified using the American Heart Association's Life's Essential 8; as detailed dietary data were unavailable, a 7-item score was used (higher scores indicated worse CVH). Multivariable Poisson regression tested associations between severe psychological distress and CVH, adjusting for potential confounders including age, race/ethnicity, sexual orientation, education level, family income, any known cardiovascular conditions, and insurance. Results: Among 1,110 pregnant individuals (representing >1.5 million pregnant individuals each year of the survey), 3.5% reported severe psychological distress (95% CI: 2.2%-5.5%), 21.7% reported moderate psychological distress (95% CI: 18.8%-24.9%), and 74.9% reported either mild or no psychological distress (95% CI: 71.4%-78.0%). Individuals reporting moderate psychological distress (adjusted rate ratio: 1.25 [95% CI: 1.13-1.38], P < 0.001) or severe psychological distress (adjusted rate ratio: 1.42 [95% CI: 1.20-1.68], P < 0.001) had lower CVH scores compared to those with mild or no psychological distress. A stepwise relation was observed between the severity of psychological distress and CVH. Conclusions: We observed a strong association between psychological distress and suboptimal CVH during pregnancy, highlighting the need to manage psychological health along with CVH in pregnant individuals.
AB - Background: The relationship between psychological health and cardiovascular health (CVH) during pregnancy is not well characterized. Objectives: The purpose of this study was to perform a cross-sectional analysis in order to assess the relationships between psychological distress and CVH among pregnant individuals in the United States. Methods: U.S. National Health Interview Survey (2013-2018) data were used for the analyses. The sample included all pregnant participants aged ≥18 years, but excluded those with missing data for the exposure, outcome, or covariates. Psychological health was measured with the 6-item Kessler scale, and severe psychological distress was defined as 6-item Kessler scale ≥13. CVH was quantified using the American Heart Association's Life's Essential 8; as detailed dietary data were unavailable, a 7-item score was used (higher scores indicated worse CVH). Multivariable Poisson regression tested associations between severe psychological distress and CVH, adjusting for potential confounders including age, race/ethnicity, sexual orientation, education level, family income, any known cardiovascular conditions, and insurance. Results: Among 1,110 pregnant individuals (representing >1.5 million pregnant individuals each year of the survey), 3.5% reported severe psychological distress (95% CI: 2.2%-5.5%), 21.7% reported moderate psychological distress (95% CI: 18.8%-24.9%), and 74.9% reported either mild or no psychological distress (95% CI: 71.4%-78.0%). Individuals reporting moderate psychological distress (adjusted rate ratio: 1.25 [95% CI: 1.13-1.38], P < 0.001) or severe psychological distress (adjusted rate ratio: 1.42 [95% CI: 1.20-1.68], P < 0.001) had lower CVH scores compared to those with mild or no psychological distress. A stepwise relation was observed between the severity of psychological distress and CVH. Conclusions: We observed a strong association between psychological distress and suboptimal CVH during pregnancy, highlighting the need to manage psychological health along with CVH in pregnant individuals.
KW - Life's Essential 8
KW - cardiovascular health (CVH)
KW - pregnancy
KW - psychological distress
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U2 - 10.1016/j.jacadv.2025.101683
DO - 10.1016/j.jacadv.2025.101683
M3 - Article
AN - SCOPUS:105001045992
SN - 2772-963X
VL - 4
JO - JACC: Advances
JF - JACC: Advances
IS - 5
M1 - 101683
ER -