Pregnancy and new motherhood present so much that is new for you to think about that your future heart health may not seem like an immediate priority. However, research is increasingly suggesting that certain complications during pregnancy may be a signal of future heart disease—and problems may be evident as soon as 10 years after pregnancy. Being aware now of the potential link between pregnancy complications and cardiovascular disease can help you take steps for a healthy future. Talk with your obstetrician/gynecologist and primary care physician about your risk factors for heart disease and whether you may benefi t from referral to a cardiologist and/or lifestyle and medication changes.
What Pregnancy Complications Appear to Be Linked to Heart Disease?
Research suggests that the following complications during pregnancy may signal a higher risk of cardiovascular disease in the future:
- Preeclampsia. This is a term that describes high blood pressure during pregnancy and post-partum. Preeclampsia is treated with medications. Early delivery may be advised in cases when blood pressure does not respond to treatment. You can learn more about preeclampsia and heart disease here and at the website of the Preeclampsia Foundation.
- Gestational diabetes. Diabetes that occurs specifi cally during pregnancy is referred to as gestational diabetes. According to the American Diabetes Association, gestational diabetes affects 18 percent of pregnancies.
- Fetal growth restriction. Fetal growth restriction describes when a developing fetus does not grow at a normal rate. This is different from when a fetus may be smaller than average but developing appropriately.
- Preterm birth. A preterm, or premature, birth is delivery of a baby before 37 weeks.
What Should I Know About Pregnancy and Heart Disease?
Being aware of a link between some pregnancy complications and heart disease means you can seek the medical care that will help you catch and treat cardiovascular disease early. Doing so is vitally important: Cardiovascular disease is the number one cause of death in women in the United States and Europe.
Research Snapshot
While more research is necessary, studies have found the following associations between pregnancy complications and cardiovascular disease:
- A history of preeclampsia increases future risks of high blood pressure, heart attack, stroke, blood clots and kidney disease.
- Women who have repeat or severe preeclampsia or preeclampsia accompanied by still birth are at greater risk of cardiovascular disease than women who have high blood pressure only and during a single pregnancy.
- Women who had growth restricted babies or who delivered preterm were found to have higher blood pressure 18 years after delivery.
- The risk of pregnancy complications and later cardiovascular disease is cumulative. Women who experienced preeclampsia, preterm birth and fetal growth restriction were found to have 7 times the risk of hospital admission or death from coronary artery disease.
What Questions Should I Ask My Healthcare Provider About Pregnancy Complications and Heart Disease?
- I had high blood pressure and/or gestational diabetes during pregnancy. Are there steps I should be taking now to monitor my heart health?
- I had a fetal growth restriction complication or delivered a preterm baby. What should I be doing for my best cardiovascular health?
- What risk factors (unrelated to pregnancy) do I have for cardiovascular disease, such as diet, family history, etc.?
- Do any of my test results indicate risk factors for heart disease, such as high cholesterol?
- Do my overall risk factors or risk factors related to pregnancy suggest that I should be referred to a cardiologist?
- Are there lifestyle or medication changes that would benefit my heart health?
What Should I Do if I Have More Questions?
Ask them. Remember that a potential link between pregnancy complications and heart disease simply means that women who experience these complications may be at higher risk of heart disease. More research is needed to confi rm these linkages and to better understand the causes behind them. However, these fi ndings are a good reminder to establish an ongoing relationship with a physician who can understand your history, note what is normal for you right now in terms of heart health, and help you monitor your heart health into the future. Periodically ask your physician, "Have we checked my heart health recently?"
SecondsCount is pleased to also provide this information as a downloadable PDF. We invite you to print it and share it with others, including your healthcare providers.
To download the PDF of this information, click here.
To review a survey developed by Women in Innovations (WIN) and the Women’s Heart Health Initiative to help obstetricians and gynecologists screen their patients for heart disease, click here.
References
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- Brown MC, Bell R, Collins C, Waring G, Robson SC, Waugh J, Finch T. Women's perception of future risk following pregnancies complicated by preeclampsia. Hypertension in Pregnancy 2012.
- Evans, C.S., Gooch, L., Flotta, D., Lykins, D., Powers, R.W. et al. (2011) "Cardiovascular System During the Postpartum State in Women With a History of Preeclampsia." Hypertension 58: 57-62.
- Fraser, A., Nelson, S., Macdonald-Wallis, C., Cherry, L., Butler, E. et al. (2012) "Associations of Pregnancy Complications with Calculated CVD Risk and Cardiovascular Risk Factors in Middle Age: The Avon Longitudinal Study of Parents and Children." Circulation. Mar 20;125(11):1367-80
- Kvehaughen, A.S., Dechend, R., Ramstad, H.B., Troisi, R., Fugelseth, D. et al. (2011). "Endothelial Function and Circulating Biomarkers Are Disturbed in Women and Children After Preeclampsia." Hypertension 58: 63-69.
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- Robb, A.O., Mills, N.L., Din, J.N., Smith, I.B.J., Paterson, F. et al. (2009). "Influence of the Menstrual Cycle, Pregnancy, and Preeclampsia on Arterial Stiffness." Hypertension 53: 952-958.
- Smith, G. C. S., Pell, J.P., Walsh, D. (2001). "Pregnancy complications and maternal risk of ischemic heart disease: a retrospective cohort study of 129 290 births." The Lancet 357: 2002-2006.
- Vikse, B., Irgens, L., Leivestad, T., Skjaerven, R., and Iversen, B. (2008). "Preeclampsia and the Risk of End-Stage Renal Disease."The New England Journal of Medicine 359(8): 800-809.
- Yinon, Y., Kingdom, J., Odutayo, A., Moineddin, R., Drewlo, S. et al. (2010). "Vascular Dysfunction in Women With a History of Preeclampsia and Intrauterine Growth Restriction. Insights into Future Vascular Risk." Circulation 122: 1846-1853.