Perinatal Psychological Health Linked to Maternal Heart Risk, AHA Urges Routine Screening
New AHA statement (April 22, 2026) calls for routine perinatal psychological health screening to lower adverse pregnancy outcomes and reduce maternal heart risk.
A new scientific statement published April 22, 2026 in the Journal of the American Heart Association urges clinicians to integrate perinatal psychological health screening and treatment into pregnancy care to reduce adverse outcomes and long-term maternal cardiovascular risk. The statement, released as part of the Go Red for Women® spotlight issue, highlights evidence tying depression, anxiety and other psychological stressors during pregnancy and the first postpartum year to worse cardiovascular outcomes. Authors say routine screening and coordinated care could help address longstanding disparities in maternal mortality and morbidity.
AHA statement connects mind and heart during pregnancy
Dr. Garima Sharma, chair of the writing group and director of preventive cardiology and women’s cardiovascular health at Inova Schar Heart and Vascular, emphasized the need to redefine maternal cardiovascular health to include psychological well-being. The statement synthesizes data showing perinatal psychological conditions are associated with adverse pregnancy outcomes and increased long-term heart disease risk. It recommends that psychological health be routinely assessed alongside traditional cardiovascular risk factors from pregnancy through one year postpartum.
Magnitude of the problem in the United States
The statement notes that cardiovascular causes are the leading contributor to maternal death in the United States and that the U.S. maternal mortality rate remains higher than in other high-income countries. Persistent disparities are highlighted: non-Hispanic Black birthing people experience maternal mortality at approximately 2.6 times the rate of non-Hispanic white people. The report also cites prevalence figures indicating roughly half of reproductive-age women report a history of a psychological health condition and elevated perinatal anxiety or depression among people from underrepresented races and ethnicities.
How psychological health affects pregnancy and the heart
Perinatal psychological health influences both behavior and physiology in ways that can raise cardiovascular risk. People experiencing depression or anxiety may adopt health behaviors that worsen heart health—such as poor diet, disrupted sleep, reduced activity or substance use—and may have difficulty adhering to medical treatments. The statement further warns that untreated perinatal psychological conditions can affect offspring neurodevelopment and family well-being, creating intergenerational consequences.
Screening recommendations for prenatal and postpartum care
The writing group recommends universal, repeated screening for psychological concerns beginning early in pregnancy and continuing at least through the first postpartum year. The Patient Health Questionnaire (PHQ‑9) and similar validated instruments are endorsed as practical tools for identifying depression and anxiety symptoms in obstetric settings. Clinicians are advised to review psychological history and current psychopharmacotherapy at the initial prenatal visit and to establish clear follow-up protocols for positive screens.
Treatment options and integrated care approaches
The statement advocates for shared decision-making and culturally responsive, family-centered care when discussing treatment options with pregnant and postpartum patients. While pharmacologic therapies may be appropriate in some cases, the authors emphasize evidence-based nonpharmacological interventions—such as counseling, cognitive behavioral therapy, exercise and stress-management techniques—especially where medication risks to the fetus or breastfeeding newborn are a concern. Multidisciplinary teams that include obstetricians, psychiatrists, psychologists, social workers and primary care clinicians are recommended to ensure continuity and coordination of care.
Systemic barriers and priorities for research and policy
Authors identify multiple barriers to integrating perinatal psychological care into cardiovascular health strategies, including stigma, fear of child welfare involvement, clinician time constraints, workforce shortages and reimbursement limitations. The statement calls for health-system incentives and delivery models that expand access to community-based supports, doulas, midwives and behavioral health professionals. It also stresses the need for long-term research on diverse populations to better understand the impact of anxiety, post-traumatic stress, adverse childhood experiences and psychosocial stressors on maternal cardiovascular trajectories.
The scientific statement was prepared by a multidisciplinary volunteer writing group on behalf of the American Heart Association’s councils and committees focused on women, underrepresented populations and a broad range of cardiovascular specialties. The authors recommend policy and practice changes to make perinatal psychological screening routine, culturally appropriate and linked to effective follow-up care.
Integrating routine psychological health screening into perinatal care, the statement concludes, is a practical step that could reduce adverse pregnancy outcomes and improve lifetime cardiovascular health for mothers, while addressing inequities in maternal health outcomes.
