Nathalie Auger1, Brian J Potter2, Jessica Healy-Profitós3, Siyi He3, Mireille E Schnitzer4, Gilles Paradis5. 1. University of Montreal Hospital Research Centre, Montreal, Quebec, Canada; Institut national de santé publique du Québec, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Quebec, Canada. Electronic address: nathalie.auger@inspq.qc.ca. 2. University of Montreal Hospital Research Centre, Montreal, Quebec, Canada; Division of Cardiology, Department of Medicine, University of Montreal Hospital Center, Montreal, Quebec, Canada. 3. University of Montreal Hospital Research Centre, Montreal, Quebec, Canada; Institut national de santé publique du Québec, Montreal, Quebec, Canada. 4. Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Quebec, Canada; Faculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada. 5. Institut national de santé publique du Québec, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada.
Abstract
BACKGROUND: The link between mood disorders and cardiovascular disease in women is unclear. We studied the association of mood disorders around pregnancy with the future risk of cardiovascular disease. METHODS: We analyzed a cohort of 1,028,109 women who were pregnant between 1989 and 2012 in Quebec, Canada. We identified women hospitalized for bipolar disorder or depression before, during, or in the 5 years after delivery, and tracked them over time to identify cardiovascular hospitalizations up to 23 years later. We calculated the incidence of cardiovascular hospitalization per 1,000 person-years, and used Cox regression to compute hazard ratios (HR) and 95% confidence intervals (CI) for the association with mood disorders. RESULTS: Incidence of cardiovascular events was higher for bipolar disorder (4.4 per 1,000 person-years) and depression (4.2 per 1,000) than no mental illness (1.8 per 1,000). Compared with no mental disorder, bipolar disorder was associated with 3.0 times the risk of cardiovascular disease (95% CI 1.92-4.73), and depression with 2.3 times the risk (95% CI 1.34-3.99). The risk of cardiovascular disease was elevated for bipolar hospitalization before pregnancy (HR 2.42, 95% CI 1.90-3.09), during pregnancy (HR 3.78, 95% CI 2.32-6.17), in the first year postpartum (HR 2.20, 95% CI 1.54-3.12), and 1-5 years postpartum (HR 2.42, 95% CI 2.04-2.86). Similar associations were found for depression. LIMITATIONS: We could only assess mood disorders that required hospitalization, and certain covariates might be underreported. CONCLUSIONS: Women with bipolar disorder or depression before, during, or after pregnancy may benefit from early prevention of cardiovascular disease.
BACKGROUND: The link between mood disorders and cardiovascular disease in women is unclear. We studied the association of mood disorders around pregnancy with the future risk of cardiovascular disease. METHODS: We analyzed a cohort of 1,028,109 women who were pregnant between 1989 and 2012 in Quebec, Canada. We identified women hospitalized for bipolar disorder or depression before, during, or in the 5 years after delivery, and tracked them over time to identify cardiovascular hospitalizations up to 23 years later. We calculated the incidence of cardiovascular hospitalization per 1,000 person-years, and used Cox regression to compute hazard ratios (HR) and 95% confidence intervals (CI) for the association with mood disorders. RESULTS: Incidence of cardiovascular events was higher for bipolar disorder (4.4 per 1,000 person-years) and depression (4.2 per 1,000) than no mental illness (1.8 per 1,000). Compared with no mental disorder, bipolar disorder was associated with 3.0 times the risk of cardiovascular disease (95% CI 1.92-4.73), and depression with 2.3 times the risk (95% CI 1.34-3.99). The risk of cardiovascular disease was elevated for bipolar hospitalization before pregnancy (HR 2.42, 95% CI 1.90-3.09), during pregnancy (HR 3.78, 95% CI 2.32-6.17), in the first year postpartum (HR 2.20, 95% CI 1.54-3.12), and 1-5 years postpartum (HR 2.42, 95% CI 2.04-2.86). Similar associations were found for depression. LIMITATIONS: We could only assess mood disorders that required hospitalization, and certain covariates might be underreported. CONCLUSIONS:Women with bipolar disorder or depression before, during, or after pregnancy may benefit from early prevention of cardiovascular disease.
Authors: Benjamin I Goldstein; Bernhard T Baune; David J Bond; Pao-Huan Chen; Lisa Eyler; Andrea Fagiolini; Fabiano Gomes; Tomas Hajek; Jessica Hatch; Susan L McElroy; Roger S McIntyre; Miguel Prieto; Louisa G Sylvia; Shang-Ying Tsai; Andrew Kcomt; Jess G Fiedorowicz Journal: Bipolar Disord Date: 2020-06-08 Impact factor: 6.744
Authors: Celia Campos-Garzón; Blanca Riquelme-Gallego; Alejandro de la Torre-Luque; Rafael A Caparrós-González Journal: Behav Sci (Basel) Date: 2021-12-16