Kalawatia M, Lucke-Wold B, Mehrunkar A. Closer look at the cardiovascular and metabolic predictors of postpartum depression. World J Psychiatry 2025; 15(6): 106283 [DOI: 10.5498/wjp.v15.i6.106283]
Corresponding Author of This Article
Mihit Kalawatia, Department of Neurosurgery, Rajarshi Chattrapati Shahu Maharaj Government Medical College, Bhausinghaji Road, Dasara Chowk, Kolhapur 416003, Mahārāshtra, India. mihit.kalawatia@gmail.com
Research Domain of This Article
Psychiatry
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Mihit Kalawatia, Department of Neurosurgery, Rajarshi Chattrapati Shahu Maharaj Government Medical College, Kolhapur 416003, Mahārāshtra, India
Brandon Lucke-Wold, Lillian S. Wells Department of Neurosurgery, University of Florida, Gainesville, FL 32608, United States
Aabhali Mehrunkar, Department of Psychiatry, Rajarshi Chattrapati Shahu Maharaj Government Medical College, Kolhapur 416003, Mahārāshtra, India
Co-corresponding authors: Mihit Kalawatia and Brandon Lucke-Wold.
Author contributions: Kalawatia M contributed to the manuscript with conceptualization, literature review, data collection, manuscript drafting, and critical revision; Kalawatia M and Lucke-Wold B contributed equally to this article, they are the co-first authors of this manuscript; Mehrunkar A contributed to the manuscript with data analysis, visualization, manuscript editing, and proofreading; Lucke-Wold B contributed to the manuscript with methodology, supervision, final review, manuscript touch-ups, and project supervision; and all authors have read and approved the final version of the manuscript.
Conflict-of-interest statement: All authors confirm no conflict of interest regarding this manuscript.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mihit Kalawatia, Department of Neurosurgery, Rajarshi Chattrapati Shahu Maharaj Government Medical College, Bhausinghaji Road, Dasara Chowk, Kolhapur 416003, Mahārāshtra, India. mihit.kalawatia@gmail.com
Received: February 21, 2025 Revised: March 17, 2025 Accepted: April 1, 2025 Published online: June 19, 2025 Processing time: 97 Days and 20.6 Hours
Abstract
Postpartum depression (PPD) is a severe mental health disorder affecting 10% to 15% of postpartum women worldwide. Pre-eclampsia is a hypertensive disorder of pregnancy that has been identified as a significant factor for PPD due to its vascular dysfunction, systemic inflammation and neurobiological alterations. The neuroinflammatory mechanisms common to both pre-eclampsia and PPD, that contribute to depressive symptoms include elevated proinflammatory cytokines (interleukin-6, tumor necrosis factor-alpha), activation of the kynurenine pathway, and oxidative stress. To critically evaluate Wu et al's study, which investigates blood pressure variability (BPV) and gestational body mass index (BMI) as independent predictors of PPD. To integrate recent findings on the metabolic and cardiovascular links between depression, pre-eclampsia, and postpartum mental health outcomes. Pre-pregnancy BMI is found to be a stronger predictor of PPD than gestational weight gain. A vascular-neuropsychiatric connection has been indicated in pre-eclamptic women, indicating a significant correlation between BPV and depressive postpartum symptoms. There is increased susceptibility to depression due to neuroinflammation contributed by blood pressure fluctuations and metabolic dysregulation. The incidence of PPD could be reduced by early identification and intervention for BP fluctuations. Early detection and intervention in high-risk pregnancies should be conducted through public health strategies that prioritize awareness, education, and accessibility to mental health care.
Core Tip: A multidisciplinary approach in integrating mental health professionals and routine strategic care is essential for high-risk patients. Blood pressure variability (BPV) should be continuously monitored as fluctuations contribute to vascular dysfunction and worsening mental health outcomes. Additionally, excessive gestational weight gain alone does not significantly increase the risk of postpartum depression (PPD). Pre-pregnancy body mass index (BMI) is a more crucial factor. Therefore, BPV and pre-pregnancy BMI are the two most critical predictors of PPD in pre-eclamptic women.
