Thinking of getting pregnant? Check your risk of heart disease first

A new study in Northwestern medicine reports that heart health in pre-pregnant women is strongly associated with the likelihood of experiencing complications during pregnancy or labor.

This study examined the presence of four cardiovascular risk factors in women before they became pregnant: smoking, unhealthy weight, high blood pressure, diabetes. These unwanted consequences include admission to the Maternal Intensive Care Unit (ICU). Premature birth, low birth weight infants and fetal death.

“It is not surprising that obesity and high blood pressure are associated with a higher risk of adverse pregnancy outcomes, but surprisingly, as risk factors increase, the risk of adverse pregnancy outcomes. pregnancy is also increasing. This is what the corresponding author, Ph.D., said. .. Sadhya Khan, associate professor of medicine and preventive medicine at Northwestern University School of Medicine Feinberg. “The sum of all risk factors is greater than the individual parts.”

A study of more than 18 million pregnancies will be published on July 21. European Journal of Preventive Cardiology, Journal of the European Society of Cardiology.

Rather than focusing on individual risk factors such as body mass index and blood pressure, the results advocate for a more comprehensive pre-pregnancy cardiovascular assessment, said Khan, a cardiologist and medical epidemiologist from the Northwest. He said.

“In reality, not all pregnancies are planned, but ideally we assess women well before they become pregnant, so we have time to optimize their health,” Khan said. .. “We also need to focus on prioritizing and promoting women’s health as a society, which not only identifies high blood pressure, but also prevents it from increasing in the first place. “

“There is a gap in the understanding of how these findings affect the long-term health of women and their children,” said Feinberg fourth-year medical student, lead author Michael Wang. Mentionned. “These data are exciting because they help design interventions and can attract more attention by filling gaps in care for these women.”

The “worst case” of pregnancy complications:

Obesity before pregnancy and high blood pressure According to Khan, there are signs that women acquire cardiovascular risk factors at a younger age. Plus, more women get pregnant later in life, giving them more time for risk factors to build up.

“Overall this created more risk factors, a complete storm of earlier onset and later pregnancy,” Khan said.

Distribution of numbers:

This study is a cross-sectional analysis of maternal and fetal data from the National Center for Health Statistics (NCHS) and collects information on all births and fetal deaths after 20 weeks of gestation. Individual data were pooled from 2014-2018 births to women aged 15 to 44.

A total of 18,646,512 pregnancies were included in the analysis. The mother’s average age was 28.6 years.

Scientists assigned women a risk factor score of 0 to 4 (eg, 0 for no risk factor, 4 for all 4 risk factors). More than 60% of women had one or more cardiovascular risk factors before pregnancy, 52.5%, 7.3%, 0.3% and 0.02% respectively have 1, 2, 3 and 4 risk factors.

The study found a progressive link between the high number of risk factors and the complexity of the pregnancy with one of four unwanted consequences. For example, mothers were 1.12 times more likely to enter intensive care with a risk factor than women without risk factors. There are 1.86 times more chances for both risk factors. All three risk factors are 4.24 times more likely. And 4 people are 5.79 times more likely to have a risk factor ..

All analyzes were adjusted for multiple maternal ages at birth, race / ethnicity, education, antenatal care, childbirth and childbirth.