FAQ: Pregnancy Complications and Your Heart

By Kathleen Doheny
WebMD Health News

Reviewed by Brunilda Nazario, MD

Sept. 22, 2015 -- You may have seen headlines linking pregnancy complications such as high blood pressure and early delivery to a later risk of dying from heart disease.

In a study published Monday, researchers found a link between the two -- and said the risk of later heart-disease death rises with more than one complication.

While it may sound scary, experts say there's no reason to panic.

WebMD asked a study author and a women's heart-health expert what else is crucial to know about the research.

What did the study look at, and what were the major findings?

Researchers looked at data gathered from nearly 15,000 women who became pregnant from 1958 to 1967, when most were in their mid-20s. They followed them through 2011 and noted which women had pregnancy complications. They found a link to death from heart disease before age 60.

Pregnancy complications that raised the risk included:

  • Having high blood pressure before or having it start during pregnancy (preeclampsia)
  • Having a low-birth-weight child
  • Delivering early
  • Having a drop in the ability of red blood cells to carry oxygen
  • High sugar levels in the urine

All boosted the risk of dying from heart disease before 60, says study senior author Barbara A. Cohn, PhD, director of the Child Health and Development Studies at the Public Health Institute. Having more than one complication raised the risk even more. Depending on the complication, and the number of them, the risk of death increased by nearly two to seven times.

Why do preeclampsia and other complications set you up for heart disease?

The complications aren't the cause of the problem, Cohn says. "They may be an indicator or predictor of how well a woman's cardiovascular system can adjust to the demands of pregnancy." Those demands are considerable, she says. "The heart has to work harder," she says, to pump enough blood throughout the body and to the unborn baby, as a woman's blood volume doubles during pregnancy.

Pregnancy is truly a ''metabolic stress test,'' says Suzanne Steinbaum, DO, director of Women's Heart Health at Lenox Hill Hospital. "It really gives you an understanding of your entire body and how well it is functioning."

She says these risk factors and preeclampsia show that a woman's heart and blood vessels already have problems. While it takes decades for heart disease to develop, these conditions lay the groundwork during pregnancy, she says.

Would these findings from the study apply to today's women?

Yes, Cohn says. It may be even stronger because women are waiting longer to have children. Older women are more likely to have high blood pressure. Also, many young women today are overweight or obese when they become pregnant, she says. Having excess weight boosts the risk of blood pressure problems.

If you have some of these pregnancy complications, what actions should you take?

"I'm not suggesting that people panic or that they are going to die next week [of heart disease]," Cohn says.

If you have or had these complications, a good first step is to have a discussion with your doctor. "This is providing an opportunity [for a woman] to discuss with her doctor a personal approach that is best for her, so she has a chance to live as long and healthy a life as possible," Cohn says. A woman at risk may decide to have blood pressure checks or other tests done more often, for instance.

Consider asking your ob-gyn for a referral to a cardiologist, Steinbaum says. "It's about being tracked and having your risk factors tracked for the rest of your life," she says. She advises patients who have had pregnancy complications to get regular exercise, eat a healthy diet, and keep a normal weight to guard their heart health.

Women should also expect their doctors to ask about pregnancy history when assessing their heart health, Steinbaum says. The American Heart Association's guidelines for preventing heart disease in women recommend that doctors include pregnancy complication history when evaluating heart disease risk, along with medical history and family history.

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SOURCES: Barbara A. Cohn, PhD, director of child Health and Development Studies at the Public Health Institute, Oakland, CA.Cohn, B. Circulation, published online Sept. 21, 2015. Suzanne Steinbaum, DO, attending cardiologist and director, Women's Heart Health, Lenox Hill Hospital, New York; spokesperson, American Heart Association's Go Red for Women campaign; author, Dr. Suzanne Steinbaum's Heart Book. American Heart Association guidelines on women's heart health, 2011.

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