CNN
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Five major pregnancy complications are risk factors for ischemic heart disease; A new study It found, with the greatest risk occurring in the decade after birth.
Ischemic heart disease refers to heart problems, including heart failure, which are caused by narrowed or dysfunctional blood vessels that reduce the flow of blood and oxygen to the heart.
Gestational diabetes and preeclampsia increased the risk of ischemic heart disease by 54% and 30%, respectively, and doubled the risk of other hypertensive disorders during pregnancy. Giving birth early – before 37 weeks – or having a low birth weight baby was associated with a 72% and 10% higher risk, respectively.
The study, published in the BMJ on Wednesday, looked at more than 2 million women in Sweden without a history of heart disease who gave birth to a singleton between 1973 and 2015.
Approximately 30% of women have at least one negative pregnancy outcome. Those who have had many negative outcomes – in the same or different pregnancies – are at an increased risk of developing ischemic heart disease.
“These pregnancy outcomes are early indicators of future risk for heart disease and can help identify high-risk women early so that early intervention can improve their long-term outcomes and prevent heart disease in these women,” said Dr. Casey. Crump, study author and professor of family medicine at the Icahn School of Medicine at Mount Sinai.
Heart disease is the leading cause of death among women in the United States, accounting for 1 in 5 female deaths US Centers for Disease Control and Prevention. This study adds Proof of installation Pregnancy provides important information about a woman’s cardiovascular health.
“What a woman experiences during pregnancy can be a stress test or a sign of future cardiovascular risk after pregnancy. And unfortunately, many women aren’t told about it,” said Dr. Tara Narula, associate professor of cardiology and division, CNN Medical Correspondent. Associate Director of the Women’s Heart Program at Lenox Hill Hospital. She did not participate in the new study.
While it’s not entirely clear why, experts say the normal changes that occur during pregnancy may mask health problems that some women have other risk factors for.
A bad pregnancy outcome can – even temporarily – cause changes in the blood vessels and heart that can persist or improve after giving birth, increasing the woman’s risk of cardiovascular disease.
Experts say that this exaggerated risk is especially worrying for women in the United States Maternal mortality rate It is many times more than other high income countries.
“There has been a change in the birth population. US women are getting pregnant at a later age, and may have one or two increased cardiovascular risk factors. “There are probably other stressors in life — depression, anxiety, isolation, obesity — that affect women in the U.S. in a wide variety of ways,” said Dr. Garima Sharma, associate professor of cardiology and director of the Cardio-Obstetrics Program at Johns Hopkins. The university’s medical school was not involved in the new study.
Pregnancy complications are carefully monitored during pregnancy, but there is insufficient evaluation and education about the effects on cardiovascular health in women after childbirth, experts say.
“And they start giving birth, maybe they have preeclampsia or gestational diabetes, and nobody’s really monitoring them. According to Narula, in fact, they are more vulnerable.
Gestational diabetes is not only a sign of diabetes, but also a sign of general cardiovascular disease. Preeclampsia and eclampsia are markers for high blood pressure risk as well as general cardiovascular risk.
Narula, a cardiologist who specializes in women’s care, regularly considers adverse pregnancy outcomes when evaluating patients and emphasizes the continued importance of this.
“The classic risk calculator that we use doesn’t have anything for pregnancy complications, but you know, for women it should be, and hopefully one day, they’ll start taking that into account,” she said.
of The American Heart Association recommends All health care professionals take a detailed history of pregnancy complications when assessing a woman’s risk of heart disease, but this is not consistent in clinical practice, especially in primary care when many women are seen, says Crump.
“We hope that raising awareness among physicians and women about these findings will lead to more women being diagnosed earlier and improving their long-term outcomes,” he said.
approx 1 in 3 Women will have bad results during pregnancy. Improving your health before you get pregnant can help avoid these problems, experts say.
“Risk reduction should start preconception, and getting your body and yourself in good shape before you get pregnant is really the first step,” Narula said.
This includes achieving and maintaining a healthy body weight through good nutrition and regular exercise, controlling blood pressure and diabetes, quitting smoking, and managing stress.
Taking action after pregnancy is equally important, as Research He estimated that only 30% to 80% of women receive a postpartum check-up 6 to 8 weeks after delivery.
“Making sure that these women are properly followed after birth and that there is a warm conversation between them [obstetrics] And [maternal-fetal medicine] For their primary care physicians or preventive cardiologists, then, it is important to be aware of cardiovascular risk factors and reduce these risks in the postpartum period after pregnancy, he said.
Experts hope that increased patient and provider awareness of the link between pregnancy and heart health will prevent birth from becoming a cause of death.
“Cardiovascular disease is preventable. It’s a leading cause of maternal death, but it shouldn’t be. If we do a better job of screening patients before conception, if we do a better job of treating them during pregnancy and childbirth, we can improve outcomes for women,” Narula said. “Bringing a new life into the world is a tragedy.” It is, and the mother will suffer some serious complications and/or death that could have been prevented.”