Abstract
Abstract only
Introduction:
There is increasing evidence linking depressive symptoms and stroke. While several studies have investigated the association between depression and stroke in the elderly population, there are few that have examined the relationship in pregnant women. Additionally, health inequities persist in pregnancy which may increase the burden of depression on pregnant Black women. The current study examined the impact of depression on stroke during pregnancy.
Methods:
We used data from the National Inpatient Sample (NIS, 2015-2018). Our sample included women between the ages of 20-44 with a maternal or neonatal admission diagnosis. Data were analyzed using weighted logistic regression models in SAS version 9.4. Covariates included age, insurance status, history of hypertension (HTN), high cholesterol (HCL), physical health comorbidities (PHC), and obesity status. PHC included those defined by the Elixhauser Comorbidity Software from AHRQ, except for hypertension, diabetes, and obesity. Depression was determined using of ICD-9 or ICD-10 codes. All analyses were stratified by race.
Results:
Overall, depression was associated with an increase in the incidence of stroke during pregnancy (aOR=1.55, 95%CI 1.11-2.18), however when stratified by race, Black women with depression had nearly 3 times higher odds of stroke (aOR=2.91, 95% CI 1.67-5.07) compared to Black women who did not have depression; there was not a statistically significant effect of depression on stroke among White women or Latinas.
Conclusions:
This study shows that, among Black women, depression is related to an increased odds of stroke during pregnancy, regardless of HTN and HCL history. While stroke primarily affects older adults, this study shows that it is important to ensure proper prenatal care and monitor Black women during pregnancy for signs and symptoms of stroke, especially if they have a PHC or history of depression.