Anticipating the arrival of a new baby can warm a woman’s heart. But pregnancy can affect her heart in other ways, too. In fact, the heart pumps about 50% more blood than usual during pregnancy. And growing evidence confirms that women who experience health complications while pregnant — including high blood pressure and gestational diabetes — face a higher risk of cardiovascular disease later in life, according to a recent scientific statement from the American Heart Association (AHA).
Cardiovascular disease, or CVD, includes heart attacks, strokes, peripheral vascular disease (narrowed arteries in the legs), and heart failure.
Which conditions and complications during pregnancy affect later heart health?
Along with high blood pressure and gestational diabetes, four additional health issues during pregnancy may raise risk for future cardiovascular problems:
- preterm birth (giving birth before the 37th week of pregnancy)
- delivering a baby that weighs less than 5 pounds, 8 ounces
- placental abruption (when the placenta separates from the uterus before birth)
- stillbirth (death of a baby before delivery).
About 10% to 15% of women experience these or other adverse pregnancy outcomes, some of which can also affect the baby’s health.
"Women who had one or more of these adverse pregnancy outcomes should be aware of their increased cardiovascular risk and share their history with their physicians, even if they gave birth decades ago," says Dr. Kathryn M. Rexrode, chief of the Division of Women's Health at Harvard Medical School and a coauthor of the AHA statement.
Developing high blood pressure, preeclampsia, or diabetes during pregnancy
Gestational hypertension is defined as a blood pressure reading of 140/90 mm Hg or higher after 20 weeks of pregnancy in a woman with previously normal blood pressure. This condition boosts the risk of developing cardiovascular disease later in life by 67%. More serious cases of high blood pressure during pregnancy are marked by signs of damage to the liver, kidneys, or other vital organs. Known as preeclampsia, this condition is linked to a 2.7-fold higher risk of later cardiovascular disease.
Women who develop type 2 diabetes during pregnancy (gestational diabetes) appear to have a 68% higher risk of future cardiovascular disease, and their odds of having type 2 diabetes after pregnancy rise 10-fold.
Compared with white women, Black, Hispanic, or Asian women tend to have more adverse pregnancy outcomes. They also have higher rates of other factors linked to heart problems. The AHA statement notes that managing heart-related risks is especially important for them.
That means following heart-healthy habits such as not smoking, eating a mostly plant-based diet, getting regular exercise, and maintaining a normal weight, says Dr. Rexrode. At-risk women should also keep close tabs on their blood pressure, cholesterol, and blood sugar to make sure these stay within the normal range. Lifestyle changes or medicines, or both, may be necessary to ensure this.
The statement also suggests that longer, more focused care following birth — sometimes referred to as the fourth trimester — could offer a good opportunity to screen women for cardiovascular disease, and provide counseling on preventing future heart-related problems. In the meantime, talk to your doctor about your entire health history — including any pregnancies — and learn about heart-healthy steps you can take today that can help you in decades to come.
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