The Impact of Potentially Traumatic Perinatal Complications on Postpartum Psychological Distress and Cardiometabolic Risk: Implications for Women’s Heart Health

Objectives: Perinatal complications are well-documented cardiovascular disease (CVD) risk factors. However, the potential for these complications to be psychologically traumatic due to their life-threatening nature—and their association with postpartum psychological distress and cardiometabolic risk—remains underexplored. This gap is important, as perinatal complications, trauma and related distress, and cardiometabolic risk factors are independently linked to CVD and may have a compounded impact when co-occurring. Methods: Data were analyzed from 2,510 predominantly low-income, racially and ethnically diverse postpartum women. We reviewed medical charts and interviews at one month postpartum to identify potentially traumatic perinatal complications, defined as severe or life-threatening complications during pregnancy, labor, delivery, and the postnatal period (up to two weeks after birth) affecting the mother or newborn. Postpartum psychological distress, including symptoms of depression, anhedonia, and anxiety, was assessed at 1 and 6 months postpartum, with PTSD symptoms assessed at six months postpartum. Composite indices of cardiometabolic risk were calculated at 6 and 12 months postpartum. Results: A range of potentially traumatic complications were identified, with 21% of women experiencing a life-threatening complication affecting mothers or newborns. Presence of complications was significantly positively associated with psychological distress, including depressive and anxiety symptoms, at 1 month postpartum. No significant associations were observed for distress at 6 months postpartum. Presence of complications was also significantly positively associated with cardiometabolic risk scores at 6 and 12 months postpartum. Conclusions: Potentially traumatic pregnancy complications are prevalent and correlate with postpartum psychological distress and cardiometabolic risk, with implications for maternal cardiovascular health.