Expert Q&A: What you need to know about pregnancy and heart health


Posted: May 24, 2021 | Word Count: 829

While there are many health complications surrounding pregnancy and giving birth, those related to cardiovascular disease are some of the most common — and the number one killer of new moms in the U.S. According to The American Heart Association's Go Red for Women Movement, heart disease and stroke account for more than 25 percent of the roughly 700 deaths in the U.S. each year due to pregnancy complications.

Pregnancy puts stress on your heart and circulatory system, and it’s important for women to pay attention to the risk factors. “Adverse pregnancy outcomes are linked to hypertension, diabetes, abnormal cholesterol and cardiovascular disease events, including heart attack and stroke, long after their pregnancies,” says Dr. Nisha I. Parikh, Chair of the American Heart Association’s scientific statement writing committee and associate professor of medicine in the cardiovascular division at the University of California at San Francisco.

“Preventing or treating risk factors early can prevent cardiovascular disease, therefore, adverse pregnancy outcomes can be a powerful window into cardiovascular disease prevention if women and their health care professionals harness the knowledge and use it for health improvement.”

Parikh discusses the risk factors and information you need to know about heart health during and after pregnancy.

What are the risk factors for cardiovascular disease?

Race, age, weight and blood pressure all play a role in determining your risk for cardiovascular disease, especially during and after pregnancy. There are many disparities when it comes to race, as Black, American Indian and Alaska Native women are two to three times more likely as white women to die from pregnancy-related cause. Experts believe many factors help explain these disparities, including insurance coverage, access to care and structural racism.

Women 35 and older are at higher risk of having or developing conditions that make pregnancy complications more likely. Such conditions include chronic high blood pressure, preeclampsia and gestational diabetes. High blood pressure during pregnancy also greatly increases risk of heart attack and heart failure.

What should I do if I have high blood pressure and plan to get pregnant?

Hypertension during pregnancy greatly increases risk of heart attack and heart failure, so it’s important to work with your health care team to lower your blood pressure before getting pregnant. Some blood pressure drugs are not advised during pregnancy, so be sure to discuss different treatment options with your physician. Discuss short-term health risks if you've had fertility treatment and tell your team if you are taking any supplements, including high-dose folic acid supplements, as some evidence suggests that high doses of prenatal supplements may increase risk of a dangerous form of high blood pressure during pregnancy.

What can I do to ensure a safer pregnancy and prevent complications?

While all women need specialized care to ensure their individual needs and health concerns are being addressed, there are many steps most women can take to improve wellness. This includes adopting a heart-healthy diet, getting enough sleep, managing stress and anxiety, and increasing your physical activity. These lifestyle interventions should start during pregnancy and continue in postpartum and through the rest of the patient’s lifespan to decrease risk of heart disease.

In addition to making healthy lifestyle choices, it is vital that women attend their prenatal care visits and have ongoing communication with their health care providers to ensure the health of the mother and baby. Some women, including those with existing heart disease, may need specialized care or monitoring, which can last from before conception until after childbirth as pregnancy can worsen some conditions and be dangerous for both a woman and her developing baby.

What can I do after pregnancy to protect against heart disease risk?

Follow-up care after pregnancy is crucial for your health. Your “fourth trimester” — the three months after childbirth — is a critical time window to screen for heart disease risk factors and improve your health trajectory. Additionally, lactation and breastfeeding may lower your risk of heart disease and metabolic disorders, including type 2 diabetes, later in life.

It’s also just as important to prioritize your wellness after pregnancy as it is during. Continue to make your health a priority by eating nutritious foods, monitoring your mental health, being active and having healthy sleep patterns. You should also continue to receive medical care and attend any necessary follow-up appointments after delivery.

“If you have any adverse pregnancy outcomes, including hypertension, gestational diabetes, preterm delivery or pregnancy loss, consider close blood pressure monitoring, type 2 diabetes and lipid screening and talk to your doctor about other risk factor modifications you can implement and CVD prevention recommendations,” Parikh says.

There is a strong connection between heart health and a healthy pregnancy. To learn more or get involved with the American Heart Association’s Go Red for Women initiative, visit goredforwomen.org/pregnancy. You can also sign up to participate in lifesaving research studies through Research Goes Red to help researchers better understand the complicated intersection between cardiovascular disease and pregnancy.

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