Pregnancy-Related Conditions Put You at Greater Risk for Cardiovascular Disease Later
January 21, 2022
Pregnancy-related conditions such as gestational hypertension and gestational diabetes may disappear after childbirth, but they still increase a woman’s risk of developing cardiovascular disease later on in life.
For these reasons, routine preventive care in the years following pregnancy is critical. Women who develop these complications during pregnancy should be monitored for lifelong heart disease risk, says UH maternal and fetal medicine specialist Christopher Nau, MD.
“Pregnancy is an incredible stress test for someone’s body. It lets you see what could happen to the body decades later,” Dr. Nau says.
“When we see these complications that can happen in pregnancy, it’s a way to predict what someone’s future may be, so it underscores the need for close follow-up after pregnancy.”
A number of pregnancy-related conditions can have long-term impact on the heart, Dr. Nau says. Hypertension (high blood pressure) disorders such as preeclampsia and gestational diabetes are the two most prominent conditions.
Preeclampsia affects about 5 percent of pregnancies in the United States. Gestational diabetes affects 2 to 10 percent of pregnancies every year, according to the U.S. Centers for Disease Control and Prevention (CDC).
A history of preeclampsia can double the risk of heart disease down the road. “The risk is higher if you’ve had it more than once," Dr. Nau says. "It’s higher for people who had it more severe or early in pregnancy.”
People with gestational diabetes are highly likely later in life to get Type 2 diabetes, which elevates risk of cardiovascular disease, Dr. Nau says. "The long-term risk may be as high as 50 to 70 percent,” he says.
Maintaining a healthy weight will significantly reduce chances of developing Type 2 diabetes, he says.
Pregnancy's Physical and Metabolic Changes
Some people are predisposed to develop gestational diabetes because of genetics, obesity or other factors. Pregnancy leads to physical and metabolic changes that push them into a diabetic condition. The same phenomenon is likely at play with hypertensive disorders, Dr. Nau says.
“The thought is pregnancy is a pretty dynamic state with your metabolism and also your cardiovascular health in general. You add that extra stress on someone’s baseline and it can manifest itself as hypertensive disease of pregnancy,” he says.
The challenge for providers is to tailor care going forward based on these pregnancy-related risks, especially among otherwise healthy patients whose risks may be overlooked.
That means educating patients about risks and vigilant screening for hypertension, prediabetes (elevated blood sugar) and Type 2 diabetes, which often are missed in younger patients, Dr. Nau says. Doing the right things with regard to diet, exercise and maintaining a healthy weight will go a long way to reducing chances of cardiovascular disease.
“Someone’s reproductive history clearly is an important part of their medical history,” he says.
“There is this huge opportunity that’s starting to become a focus, and that is that care transition after pregnancy.”
University Hospitals is a trusted resource for many expectant parents in communities across Northeast Ohio. Our experienced team uses the latest evidence-based childbirth practices, providing personalized, family-centered delivery services tailored to your unique needs. Learn more about pregnancy and childbirth services at University Hospitals.