Pregnancy Complications May Predict Heart Trouble Later

MONDAY, Feb. 20 (HealthDay News) — Certain complications during
pregnancy appear to raise the mother’s risk of cardiovascular disease
during middle age, a new study has found.

Women with high blood pressure in pregnancy, known as preeclampsia, or
pregnancy-related diabetes were more likely to have cardiovascular disease
risk factors at around 50, the British researchers found. The risk was
greater with preeclampsia.

“For women, this study suggests that if they have experienced any of
the pregnancy complications [evaluated], they may consider seeking advice
regarding effective interventions and lifestyle changes in order to
modify their CVD [cardiovascular disease] risk,” said study leader Abigail
Fraser, a research fellow at the University of Bristol School of Social
and Community Medicine.

For women not yet pregnant, maintaining a healthy weight before getting
pregnant may help them avoid the problems, Fraser said.

Moms-to-be with preeclampsia were 31 percent more likely to have risk
factors for heart disease at around age 50 than those who had normal
blood pressure during pregnancy. They tended to be heavier and have higher
blood pressure and irregular blood sugar control than women with a healthy
pregnancy.

Women who developed diabetes in pregnancy, called gestational diabetes,
were 26 percent more likely to have heart-disease risk factors,
particularly abnormally high blood sugar levels.

For the study, published Feb. 20 in the journal Circulation, the
researchers looked at the pregnancies of more than 3,400 women enrolled in
the Avon Longitudinal Study of Parents and Children in the early
1990s.

Nearly 30 percent had one complication, and about 5 percent had two.
Besides high blood pressure and diabetes, the researchers were interested
in whether preterm delivery and babies born small or large for gestational
age affected heart disease risk later.

After 18 years, they reassessed the women, who then averaged 48 years
old. They used the Framingham prediction score, a respected measure, to
evaluate their risk of getting cardiovascular disease in the next 10
years.

Giving birth to babies large for gestational age was linked with higher
blood sugar and wider waists. Giving birth to babies small for gestational
age and delivering before term was linked with higher blood pressure.

The findings make sense to Marie Frazzitta, a nurse practitioner and
coordinator of the North Shore University Hospital’s Center for Diabetes
in Pregnancy, Manhasset, N.Y.

“Pregnancy is like a stress test that can identify what chronic
conditions a woman may be susceptible to later in life,” she
explained.

Dr. Tara Narula, a cardiologist at Lenox Hill Hospital, New York City,
agreed. “Pregnancy may be a unique point in time where physicians get a
window into a woman’s future risk for cardiovascular disease,” she said.
Factors such as preterm delivery and baby’s size may help predict a
woman’s long term risk of developing cardiovascular disease or risk
factors, she said.

“If physicians can use the information gained during pregnancy to
appropriately manage a woman’s risk, we may be able to limit the number of
deaths caused by CVD, the number one killer of American women,” Narula
said.

She said the study provides good information, but is limited in that
“the follow-up occurred at an age in women (younger than 50) when CVD
events are low in general.”

The study, which builds on previous research, was funded by the U.S.
National Institute of Diabetes and Digestive and Kidney Disease, the
British Heart Association and Wellcome Trust.

More information

To learn more about heart disease risk, go to the American Heart
Association.

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