Epidemiology of bipolar disorder with concomitant pregnancy-induced hypertension and associated pharmacotherapies in the United States, Canada and Saudi Arabia over a five−year period (2019-2023)

BACKGROUND: Rates of hypertensive disorders affecting pregnancy are increasing, and bipolar disorder is more common in pregnancy than previously thought. OBJECTIVE: The authors investigated differences in the incidence of hypertensive disorders of pregnancy between those with and without bipolar disorder (BPD) and between those receiving and not receiving pharmacotherapy for BPD. Differences in the incidence of hypertensive disorders of pregnancy in those with BPD between those on prophylactic aspirin (ASA) and not, were also examined. METHODS: EPIC COSMOS was used to examine records from 2019 to 2023. RESULTS: The authors found a meaningful difference in proportions between those with and without BPD when observing development of hypertensive disorders of pregnancy across years. Slightly increased odds of hypertensive disorders were found among those reporting BPD pharmacotherapy compared to those not. Slightly increased odds of hypertensive disorders occurred in those with BPD reporting ASA. CONCLUSIONS: The increased odds among those reporting BPD pharmacotherapy could be due to sequelae of disease, medication used, or comorbidities. These findings further corroborate prior evidence of the increasing prevalence of both maternal health complications and mental health disorders int eh United States.