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Blood Pressure, Depression, and Suicidal Ideation Among Pregnant Women with HIV

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Abstract

Although prior research has examined associations between blood pressure (BP), depression, and suicidal ideation, few studies have examined this in high-risk populations such as pregnant women with HIV (WHIV). The current study examined the association of BP with depression and suicidal ideation among pregnant WHIV (n = 217) in rural South Africa. BP data (measured ≤ 1 month before the study visit) was extracted from medical records. Depressive symptomatology and suicidal ideation were assessed using the Edinburgh Postnatal Depression Scale. Diastolic BP was positively associated with both suicidal ideation and depressive symptomatology, even after controlling for demographic variables, gestational age, and intimate partner violence. These findings suggest that WHIV with elevated BP may be at greater risk for antenatal depression and suicidal ideation. Future research should utilize longitudinal designs to examine potential mechanisms and the directionality of the relationship, as well as other contributing factors.

Resumen

Aunque investigaciones anteriores han examinado las asociaciones entre la presión arterial (PA), depresión e ideación suicida, pocos estudios han examinado esto en poblaciones de alto riesgo, como las mujeres embarazadas con VIH. El estudio actual examinó la asociación de la PA con la depresión y la ideación suicida entre mujeres embarazadas con VIH (n = 217) en zonas rurales de Sudáfrica. Los datos de PA (medidos ≤ 1 mes antes de la visita del estudio) se extrajeron de los registros médicos. La sintomatología depresiva y la ideación suicida se evaluaron mediante la Escala de depresión posnatal de Edimburgo. La PA diastólica se asoció positivamente tanto con la ideación suicida como con la sintomatología depresiva, incluso después de controlar variables demográficas, edad gestacional y violencia de la pareja íntima. Estos hallazgos sugieren que mujeres embarazadas con VIH con PA elevada puede tener un mayor riesgo de depresión prenatal e ideación suicida. Las investigaciones futuras deberían aprovechar diseños longitudinales para examinar los posibles mecanismos y la direccionalidad de la relación, así como otros factores contribuyentes.

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Acknowledgements

The authors would like to thank the study staff and the women participating in this study, without whom this work would not have been possible.

Funding

This work was supported by the National Institute of Child Health and Human Development (R01HD078187; PI: DLJ), with additional support from the Miami Center for AIDS Research at the University of Miami Miller School of Medicine, funded by the National Institutes of Health (P30AI073961). VJR’s work on this manuscript was partially supported by a Ford Foundation Fellowship, administered by the National Academies of Sciences, Engineering, and Medicine.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1400 NW 10th Ave., Suite 404A, Miami, FL, 33136, USA

    Lissa N. Mandell, Manasi S. Parrish, Violeta J. Rodriguez, Stephen M. Weiss & Deborah L. Jones

  2. Department of Psychology, University of Georgia, Athens, GA, USA

    Violeta J. Rodriguez

  3. Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA

    Maria L. Alcaide

  4. Department of Human and Social Capabilities, Human Sciences Research Council, Pretoria, South Africa

    Karl Peltzer

  5. Department of Research Administration and Development, University of Limpopo, Turfloop, South Africa

    Karl Peltzer

  6. Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung, Taiwan

    Karl Peltzer

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  1. Lissa N. Mandell
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  2. Manasi S. Parrish
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  4. Maria L. Alcaide
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  6. Karl Peltzer
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  7. Deborah L. Jones
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Contributions

SMW, KP, and DLJ designed and directed the project. LNM, VJR, MLA, and DLJ planned the analyses presented in this manuscript. VJR conducted the statistical analyses. MSP, LNM, and DLJ interpreted the results. LNM, MSP, and VJR drafted the manuscript. All authors revised the manuscript for important intellectual content.

Corresponding author

Correspondence to Deborah L. Jones.

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The authors declare that they have no conflicts of interest.

Consent to Participate

Participants provided written informed consent prior to study procedures.

Ethical Approval

Before beginning this study, the researchers obtained ethical approval from the Human Sciences Research Council Research Ethics Committee (protocol approval number REC4/21/08/13), the University of Miami Miller School of Medicine Institutional Review Board (IRB ID: 20130238), and the Mpumalanga Provincial Government. All study procedures were in accordance with the ethical standards of the responsible ethics committees and the Declaration of Helsinki.

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Mandell, L.N., Parrish, M.S., Rodriguez, V.J. et al. Blood Pressure, Depression, and Suicidal Ideation Among Pregnant Women with HIV. AIDS Behav 26, 1289–1298 (2022). https://doi.org/10.1007/s10461-021-03486-4

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