Mental Health Outcomes Following a Pregnancy Complicated by Cardiovascular Disease: A Scoping Review

This scoping review seeks to answer the following questions: 1. What is the prevalence of post-pregnancy depression, anxiety, or PTSD following a cardiovascular disease in pregnancy? 2. Does the prevalence of post-pregnancy depression, anxiety, or PTSD differ amongst different types of cardiovascular diseases in pregnancy? 3. Are people who experienced a cardiovascular disease in pregnancy more likely to develop post-pregnancy depression, anxiety, or PTSD compared to people who did not experience a cardiovascular disease in pregnancy? 4. Does the association between cardiovascular disease in pregnancy and post-pregnancy depression, anxiety, or PTSD differ by type of cardiovascular disease? The primary outcome will be the percent of participants within the sample that meet criteria for depression, anxiety, or PTSD after the pregnancy complicated by cardiovascular disease, according to the scales used in the study. The cutoff values reported by the authors for each scale to meet the criteria for depression, anxiety, or PTSD will be used and documented. If only mean score numbers or raw score numbers are reported, we will contact the study authors to obtain the percent of participants meeting the criteria for depression, anxiety and PTSD based on the scales utilized in the study . If the authors do not respond within two months, we will report the mean score or raw score numbers and we will provide additional information to contextualize these scores, such as mean survey scores in the general postpartum population. The secondary outcome will be the effect size for the association between cardiovascular disease in pregnancy and mental health outcomes (depression, anxiety, or PTSD). This may be reported as a risk ratio, odds ratio, or difference in means. Findings from the scoping review will be reported as a narrative synthesis in which prevalences of post-pregnancy depression, anxiety and PTSD are presented for each study. Effect sizes for the association between preexisting cardiovascular disease and post-pregnancy depression, anxiety and PTSD will also be reported. Prevalences of depression, anxiety, and PTSD and effect sizes for these associations will also be examined by type of cardiovascular disease, grouped by the World Health Organization Pregnancy Risk Classification for Women with Preexisting Cardiovascular Disease to assess trends in prevalence by disease severity. This information will be presented and discussed in the text and within tables. Each study will include the following information in the tables: first authors, publication year, country, study design, aim of study, participant characteristics, number of participants, assessment of pre-pregnancy psychiatric history, pregnancy studied (i.e. first pregnancy, most recent pregnancy), average time since pregnancy, parity and gravidity, type of cardiovascular diseases, assessment of cardiovascular diseases, types of mental illness studied, assessment of mental illnesses, prevalence of mental illnesses, statistical analyses, and effect sizes for the association between preexisting cardiovascular disease and post-pregnancy anxiety, depression, and PTSD.