Five major pregnancy complications are strong lifelong risk factors for ischemic heart disease. new research The greatest risk occurs in the first decade after birth.
Ischemic heart disease refers to heart problems, including heart attacks, caused by narrowed or malfunctioning blood vessels that reduce the flow of blood and oxygen to the heart.
In this study, gestational diabetes and pre-eclampsia increased the risk of ischemic heart disease by 54% and 30%, respectively, while other hypertensive disorders during pregnancy doubled the risk. Premature birth or low birth weight before 37 weeks was associated with a 72% and 10% increased risk, respectively.
The study, presented Wednesday in the BMJ, followed a cohort of more than two million Swedish women with no history of heart disease who gave birth to live infants alone between 1973 and 2015.
Approximately 30% of women experienced at least one adverse pregnancy outcome. Those who experienced multiple adverse outcomes in the same or different pregnancies were shown to have an even higher risk of ischemic heart disease.
“These pregnancy outcomes are early signals of future heart disease risk, identifying at-risk women early and enabling early intervention to improve long-term outcomes and prevent the development of heart disease in these women.” It helps,” said Dr. Casey. Crump, author of the study and professor of family medicine at Icahn School of Medicine, Mount Sinai, said:
Heart disease is the leading cause of death for women in the United States, accounting for 1 in 5 female deaths. U.S. Centers for Disease Control and Prevention. This study evidence Pregnancy provides important information about a woman’s cardiovascular health.
“What happens to women during pregnancy is like a post-pregnancy stress test or a marker of future cardiovascular risk. Unfortunately, many women don’t know this from anyone.” said Dr. Tara Narula, a CNN medical correspondent and associate professor of cardiology. Associate Director of the Women’s Heart Program at Lenox Hill Hospital. She was not involved in new research.
It’s not entirely clear why, but experts say the normal changes that occur during pregnancy may reveal potential health problems in some women with certain risk factors. increase.
Negative effects on pregnancy outcome, even temporarily, can lead to changes in the blood vessels and heart that persist or progress after childbirth, increasing the risk of cardiovascular disease in women.
This increased risk is of particular concern for women in the United States, experts say. maternal mortality several times higher than in other high-income countries.
“There has been a shift in the birthing population. Women in the United States are getting pregnant at a later age and probably have already developed one or two cardiovascular risk factors. factors may be affecting women in the U.S. University medical schools were also not involved in the new study.
Complications during pregnancy are closely monitored during pregnancy, but there is little evaluation or education about the impact on women’s cardiovascular health after giving birth, experts say.
“And they gave birth and could have had pre-eclampsia or gestational diabetes and nobody really followed up. No,” Narula said.
Gestational diabetes is not only an increased risk of diabetes, but also a marker of cardiovascular disease in general. Pre-eclampsia and eclampsia are markers of hypertension risk and cardiovascular risk in general.
Narula, a cardiologist who specializes in women’s care, regularly considers the adverse effects of pregnancy when evaluating her patients, and stresses the continued need for this.
“The traditional risk calculator we use doesn’t include anything about pregnancy complications, but it should be for women. Someday, women will take that into account.” I hope it will,” she said.
of Recommended by the American Heart Association All health professionals take a detailed history of pregnancy complications when assessing a woman’s risk of heart disease, but this is not consistently done in clinical practice, especially in primary care where most women are found. do not have.
“By increasing awareness of these findings among physicians and women, we hope that more of these women will be screened earlier and have improved long-term outcomes,” he said. .
almost one third Women will have adverse consequences for pregnancy. Experts say you can avoid these problems by improving your health before you get pregnant.
“Reducing risk has to start with preconceived notions, so getting your body and yourself as healthy as possible before you get pregnant is really the first step,” Narula said.
This includes achieving and maintaining a healthy weight through proper diet and regular exercise, managing high blood pressure and diabetes, quitting smoking, and managing stress.
Post-pregnancy behavior is equally important. research estimates that only 30-80% of women undergo postnatal check-ups 6-8 weeks after giving birth.
“Make sure these women are actually being followed up properly after giving birth and that there is a warm handover between them. [obstetrics] When [maternal-fetal medicine] You can talk to your doctor or preventative cardiologist about optimizing cardiovascular risk and reducing these risk factors post-pregnancy in the postpartum window,” Sharma said.
Experts hope that increased patient and donor awareness of the relationship between pregnancy and heart health will prevent childbirth from becoming a cause of death.
“Cardiovascular disease is preventable. It is a leading cause of maternal mortality, but it doesn’t have to be. Better screening of pre-pregnant patients and better treatment of pregnant and post-natal patients can improve the health of women. We can improve outcomes,” said Narula. “It’s a tragedy that you brought new life into the world and your mother suffers horrific complications and preventable deaths.”