Pregnancy Complications Can Predict Heart Trouble Later

by Lodovica Trevisan

Pregnancy Complications and Heart TroubleFor years, most moms-to-be and their doctors considered preeclampsia and gestational diabetes as temporary medical problems. Because in both cases, the symptoms usually go away soon after the baby's birth, the long-term implications can go unaddressed.

Nicole shares, "I had my first pregnancy when I was 18 years old. It was wonderful until I hit 35 wks. I was diagnosed with preeclampsia and she was delivered that same day with no problems."

Now, experts have found that complications like Nicole developed during her pregnancy serve as red flags. She could be more prone to develop heart problems later in life.

These medical findings led the American Heart Association to issue updated guidelines. A problem pregnancy is considered a risk factor for a woman to develop heart problems, along with such well-established dangers as smoking and high cholesterol.

3416 women participated in a prospective cohort in the Avon Longitudinal Study of Parents and Children (ALSPAC), which began in the early 1990s. Cardiovascular disease risk was measured 18 years after pregnancy when the women were, on average, 48 years old.

The study found that women who had gestational diabetes or preeclampsia during pregnancy had about a 30 percent increased risk of CVD after 18 years of follow-up, compared with those who had not had these complications.

Preeclampsia Risk: Now and Later

Preeclampsia is characterized by a rapid rise in blood pressure and protein in the urine after 20 weeks gestation.

Short term complications: The mother's condition typically improves soon after the baby is born.

The baby faces a risk of premature birth as the mother's blood pressure elevates. This can be life-threatening or lead to respiratory difficulties and other developmental problems.

Long term effect: Women with a history of preeclampsia have approximately double the risk of cardiac disease later in life compared to women with uncomplicated pregnancies.

Gestational Diabetes Risks: Now and Later

Gestational diabetes affects as many as 10 percent of pregnant women.

Short-term complications: Their babies might be born unusually large, leading to risk of premature birth or complicated delivery.

Long-term effects: Women who developed diabetes in pregnancy were 26 percent more likely to have heart-disease risk factors, particularly abnormally high blood sugar levels.

Offspring of mothers who experienced gestational diabetes were more likely to be overweight at age 18 than children whose mothers didn't have the condition. The greater body mass in early adulthood was likely due to the diabetes, and not to family genetic or other factors, the researchers concluded.

A Finnish study published in 2009 in the journal Stroke found a higher risk of stroke in adults born after pregnancies complicated by preeclampsia or high blood pressure.

What You Can Do

Pregnancy offers a glance into a woman's future risk for cardiovascular disease. Complications can serve a warning for longer-term health concerns.

"A woman who experiences complications during pregnancy should be proactive and ask her doctor about future cardiovascular disease risk and steps she should take to modify her risk," says Abigail Fraser, research author.

Following a High-Risk Pregnancy

Pregnancy is a rigorous cardiovascular stress test. Experts believe the results of which should not be ignored after the 6-week postpartum visit.

Learn your personal risk factors and work to eliminate or lower those. Your healthy heart plan might include a healthier diet, losing weight, adding regular exercise to your week or learning to manage stress. No matter which changes you should make, your pregnancy complication has given you a heads-up and now you've got a chance to make those changes.

Before Pregnancy

Are you overweight or obese and planning a pregnancy? Experts suggest that you take steps to lose weight before conceiving.

"Women quit smoking, and stop drinking for their kids," Sharonne Hayes, a Mayo Clinic cardiologist, says. "If you lose 40 pounds and wait till next year, your baby will be healthier."

While taking such steps might not prevent the pregnancy complication, it does lower your risk for both gestational diabetes and preeclampsia.

Medical references:
- Fraser A, Nelson SM, Macdonald-Wallis C, et al. (February 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 2012.

Bukowski R et al. (March 2012) Delivery of a small for gestational age infant and greater maternal risk of ischemic heart disease. PLoS ONE 2012 Mar; 7:e33047.