Pregnancy and motherhood present so much that’s new for you to consider. As a result, your future heart health may not seem an immediate priority. However, research increasingly suggests that certain complications during pregnancy may signal future coronary artery disease (CAD), more commonly known as “heart disease.”1 Being aware now of the potential link between pregnancy complications and heart disease can help you take steps for a healthy future. Talk with your obstetrician/gynecologist (OB-GYN) and primary care physician about your risk factors for heart disease and whether you may benefit from referral to a cardiologist and/or lifestyle and medication changes.
Preeclampsia and heart disease
Awareness of the link between some pregnancy complications and heart disease means you can seek medical care to help you catch and treat heart disease early. Doing so is vitally important, as heart disease is the number one cause of death in women* (assigned female at birth) in the United States.2
One pregnancy complication that is a significant warning sign for heart disease after pregnancy is preeclampsia, which is a term that describes high blood pressure during or immediately following pregnancy. In fact, the American Heart Association’s heart disease guidelines consider preeclampsia as a risk factor for heart disease as strong as a failed stress test—a test commonly used to identify existing heart disease.
Preeclampsia is typically treated with medications; however, early delivery may be advised if blood pressure doesn’t respond to treatment. According to the Preeclampsia Foundation, 5%–8% of all pregnancies are affected, and preeclampsia is a leading cause of infant and mother illness and death worldwide.
Research3 has found that preeclampsia can be an early indicator of future cardiovascular problems:
- Individuals with a history of preeclampsia double their risk of heart attack, stroke, and blood clots within five to 15 years after pregnancy.
- Individuals who have repeat or severe preeclampsia or preeclampsia accompanied by stillbirth (death of a baby before delivery) are at greater risk of heart disease than those who have high blood pressure only or preeclampsia during a single pregnancy.
- Some individuals are unaware that preeclampsia and other pregnancy complications can signal heart disease risk. A study found that 13% of individuals screened for heart disease risk factors during an OB-GYN visit had three or more of which they weren’t aware of.
Medical researchers don’t know precisely how and why preeclampsia and future heart disease are linked. Still, one theory is that pregnancy's additional strain on the cardiovascular system unmasks early existing heart disease. However, more research is necessary to understand the connection. For more information about preeclampsia and heart disease, visit the Preeclampsia Foundation’s website.
Other pregnancy complications linked to heart disease
Research suggests that the following complications during pregnancy may also signal a higher risk of heart disease in the future:
- Gestational diabetes – Diabetes that occurs specifically during pregnancy is gestational diabetes. According to the American Diabetes Association, gestational diabetes affects 10% of pregnancies.
- Fetal growth restriction – Fetal growth restriction describes when a developing fetus doesn’t grow normally. This differs from when a fetus may be smaller than average but developing appropriately.
- Preterm birth – A preterm, or premature, birth is the delivery of a baby before week 37 of pregnancy.
According to the American Heart Association (AHA):
- High blood pressure in pregnancy increases the risk of heart disease later in life by 67% and the odds of a stroke by 83%.
- Preeclampsia during pregnancy is associated with a 2.7 times higher risk of developing heart disease later.
- Having gestational diabetes increases the risk of heart disease by 68% and increases the risk of type 2 diabetes after pregnancy by 10-fold.
- A preterm delivery doubles the risk of developing heart disease and is strongly linked with later developing heart disease and stroke.
- Placental abruption (separation of the placenta from the uterus before childbirth) is associated with an 82% increased risk of heart disease.
- Stillbirth (baby's death before delivery) is associated with about twice the risk of heart disease.
Questions to ask your doctor about pregnancy complications and heart disease
The following questions can help you discuss pregnancy complications and heart disease with your doctor. Print out or write down these questions and take them to your next doctor’s appointment. Taking notes can help you remember your doctor’s response when you get home.
- I had high blood pressure and/or gestational diabetes during pregnancy. Are there steps I should be taking now to monitor my heart health?
- I had a fetal growth restriction complication or delivered a preterm baby. What should I be doing for my best cardiovascular health?
- I had preeclampsia during one or more pregnancies. Should I be referred to a cardiologist?
- What risk factors (unrelated to pregnancy) do I have for heart disease, such as diet, family history, etc., and how can I reduce my risk?
- Are there lab tests or diagnostic tests that you recommend based on my history of preeclampsia and other risk factors?
- Do my test results indicate risk factors for heart disease, such as high cholesterol?
- Do my overall risk factors or risk factors related to pregnancy suggest that I should be referred to a cardiologist?
- Are there lifestyle or medication changes that would benefit my heart health?
*The term “women” in the context of “women’s cardiovascular health” applies to individuals assigned female at birth (AFAB) who have a female biological reproductive system, which includes a vagina, uterus, ovaries, Fallopian tubes, accessory glands, and external genital organs.
*The term “men” in the context of “cardiovascular health” applies to individuals assigned male at birth (AMAB) who have a male biological reproductive system, which includes a penis, scrotum, testes, epididymis, vas deferens, prostate, and seminal vesicles.