Only
about 40 percent of women who gave birth in the United States in 2019 had good
heart health before the pregnancy, according to research published today in
Circulation, the journal of the American Heart Association (AHA).
The
major factors in low pre-pregnancy health noted by researchers included excess
weight, hypertension, and diabetes.
Age
also played a role. About 42 percent of women from 30 to 34 had good heart
health versus 37 percent of women ages 40 to 44.
Geographically,
good heart health was lower in the South and Midwest compared with the West and
Northeast.
“Many
women only begin having regular healthcare visits once they become pregnant,”
Dr. Natalie A. Cameron, a lead study author and an internal medicine specialist
and instructor at Northwestern University’s Feinberg School of Medicine in
Chicago, said in a statementTrusted Source.
“If
women already have… obesity, high blood pressure, or diabetes prior to
pregnancy, it is often not diagnosed until pregnancy. However, if identified
prior to pregnancy, their healthcare clinician can help them manage and
optimize these conditions before pregnancy,” said Cameron.
Cardiovascular
disease is the leading causeTrusted Source of pregnancy-related death in the
United States.
Heart
health affects mother and baby
Dr.
Nicole Weinberg, cardiologist at Providence Saint John’s Health Center in Santa
Monica, California, told Healthline that being pregnant increases stress on the
body over a long period of time.
“If
there’s something slightly amiss, it’s amplified when you’re pregnant. High
blood pressure and other problems before pregnancy become exacerbated with
pregnancy,” said Weinberg.
The
result is a larger and more substantial risk for cardiovascular disease, she
said.
“And
those are babies that may grow up with a variety of other problems,” said
Weinberg.
Dr.
Kecia Gaither is double board certified in OB-GYN and maternal fetal medicine,
as well as director of perinatal services at NYC Health + Hospitals/Lincoln in
the Bronx.
“There
is an increase in heart rate, vascular volume, and cardiac output with a
decrease in vascular resistance. If cardiovascular health is less than optimal,
these changes can preclude to cardiac dysfunction,” Gaither told Healthline.
Depending
on the underlying cardiovascular issue, the consequences for both mother and baby
can be disastrous, she said.
“There
may be the need for fetal surveillance frequently for growth and well-being. If
the mother has a congenital cardiac defect, there is a risk that the fetus may
have the same cardiac issue. Fetal sonographic cardiac evaluation, known as a
fetal echocardiogram, may need to be evaluated by a pediatric cardiologist,”
said Gaither.
Achieving heart health before pregnancy
The
things that are good for your heart are good for your pregnancy, said Weinberg.
“Eating
healthy, getting a good night’s sleep, and exercising — it doesn’t have to be
crazy or intensive — all these help the heart. They also help you get pregnant
and have a good, healthy pregnancy,” she said.
Regular
health checkups can help catch problems early.
If
you’re planning on getting pregnant and have a condition such as hypertension,
diabetes, obesity, or a history of preeclampsia or maternal congenital cardiac
malformation, Gaither recommends seeing a doctor for an assessment.
“Preconception
evaluation of a woman with risk factors which may exacerbate cardiac
malfunction may be offered,” she said. “Such as weight loss advice, dietary
consultation with a nutritionist, addition or change in medications, etc., so
that pregnancy can begin in the best cardiac shape possible.”
Improving
heart health during pregnancy
In
the United States, there are about 700Trusted Source pregnancy-related deaths
each year, almost two-thirds of which could be prevented, according to the
Centers for Disease Control and Prevention.
“I
think a healthy diet and exercise are invaluable for people headed in the wrong
direction,” said Weinberg.
She
noted that despite your best efforts, you can still have cardiovascular issues.
“Sometimes
medication therapy is needed, and it shouldn’t be considered a weakness. It’s
really just about keeping you and your baby healthy through this first stress
test of life,” said Weinberg.
Good
heart health is important well beyond pregnancy.
A
2019 studyTrusted Source concluded that better cardiovascular health in early
pregnancy is associated with better cardiovascular health 10 years after
pregnancy.
“Having
something like preeclampsia, gestational diabetes, or hypertension in pregnancy
or heart failure associated with birth puts you at risk later in life,” said
Weinberg.
“See
a cardiologist. Be aware. Identify the risks and be as aggressive as possible
in getting those risk factors modified,” she said.
Source:
Healthline