The Surprising Heart Risks of High-Risk Pregnancies
Heart disease is usually the last thing on a woman’s mind during pregnancy. But if her pregnancy is high risk, her future heart health may be on the line, accumulating research suggests.
Recent studies show that women with high-risk pregnancies or complications, such as gestational diabetes and preeclampsia—a hypertensive condition related to pregnancy—have as much as an eight-fold increased risk of heart disease later in life. A new study from the Netherlands found that more than a third of women who had experienced early onset preeclampsia had hypertension at about age 40, compared to just 14 percent of women with uncomplicated pregnancies. And more than 18 percent of women with a history of preeclampsia were diagnosed with the metabolic syndrome—a constellation of symptoms including hypertension, a large waist circumference and high triglycerides—at midlife, compared to just 1.8 percent of those with normal pregnancies. Overall, women who have a pregnancy complicated by preeclampsia are twice as likely as women with normal pregnancies to die from heart disease.
Gestational diabetes—a type of diabetes limited to pregnancy—also increases the risk for later heart woes, including stroke, in addition to type 2 diabetes. In a study from the Journal of the American Heart Association, researchers measured the thickness of carotid artery walls among women who had given birth and were followed for an average of 12 years after pregnancy. The women who had developed gestational diabetes during pregnancy had thicker artery walls, suggesting the beginnings of dangerous plaque, which can result in heart attacks and stroke.
Just having a baby late in life may boost the risk of heart problems post-pregnancy, according to new data from the Women’s Health Initiative, and the effect is long lasting. When researchers looked at data for 72,221 women ages 50 to 79 who had had delivered at least one child, they found that those who had had a baby after age 40 were 50 percent more likely to experience a hemorrhagic stroke in their later years. The finding held even after accounting for age, race, blood pressure, alcohol use, smoking status and diagnosis of heart failure or atrial fibrillation—factors that increase stroke risk.
The data suggest that pregnancy presents a kind of stress test for women’s hearts, predicting health challenges they may face in the future. Yet many women have no idea that problematic pregnancies are early warning signs of potential troubles ahead.
Fortunately women who have pregnancy difficulties can change their health fate with preventive measures. Eating a healthy diet and exercising, with a doctor’s OK, can help to keep the heart strong during and after pregnancy. Women should stick to pregnancy weight gain guidelines (25 to 35 lbs. for normal weight women; 15 to 25 lbs. for those who are overweight) to avoid putting on pounds that will be difficult to lose after the baby’s birth—and put extra stress on the heart.
After pregnancy, women and their doctors should be vigilant about risk factors, including rises in blood pressure and blood sugar, and maintain a healthy weight. Doctors may also consider more rigorous heart-related screenings for patients who have experienced high-risk pregnancies. While the cardiovascular risks of such pregnancies are life-long, they aren’t inevitable.