Associations of depression and depressive symptoms with preeclampsia: results from a Peruvian case-control study

The study included 339 preeclamptic cases and 337 normotensive controls. Depression and depressive symptoms during pregnancy were assessed using the Patient Health Questionnaire (PHQ-9). Odds ratios (OR) and 95% confidence intervals (CI) were estimated from logistic regression models.The prevalence of moderate depression was 11.5% among cases and 5.3% among controls. The corresponding figures for moderate-severe depression were 3.5% for cases and 2.1% for controls. Compared with non-depressed women, those with moderate depression had a 2.3-fold increased risk of preeclampsia (95% CI: 1.2–4.4), while moderate-severe depression was associated with a 3.2-fold (95% CI: 1.1–9.6) increased risk of preeclampsia. Associations of each of the 9-items of the PHQ-9 depression screening module with preeclampsia risk were also observed.Our findings are consistent with the only other published report on this topic. Collectively, available data support recent calls for expanded efforts to study and address depression among pregnant women.There is mounting evidence that depression is an independent risk factor for the progression of cardiovascular disease (CVD) [1]. Many factors can contribute to an increased risk for CVD in depressed patients. The concept of a bio-behavioral model to explain the relationship between depression and CVD is gaining support in the literature [2,3]. This model includes characteristics ranging from an increased presence of classical risk factors for CVD (such as smoking, inactivity, hypertension, and diabetes) to changes in the immune system and dysregulation of the autonomic nervous system. Platelets from depressed patients have also been found to have increased 5-hydroxytryptamine 2 (5-HT2) binding density, suggesting that depressed patients may be at increased risk for serotonin-mediated platelet activation and coronary artery vasoconstriction [1].Preeclampsia, a major cause of perinatal morbidity and mortality, occurs in 5–7% of pregnancies and is di