HEART HEALTH & PREGNANCY
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- 3 min read
What is cardiovascular disease?
Cardiovascular disease (CVD) refers to a group of conditions that affect the heart and blood vessels.
This includes:
Coronary artery disease – narrowing of the arteries resulting in restricted blood flow to the heart. Arteries are blood vessels that bring oxygen-rich blood from the heart to the rest of your body
Stroke – a medical emergency where your brain is not getting enough blood due a blockage or a blood vessel bursting
Heart failure – heart is unable to pump enough blood to the body
Arrythmia – abnormal heart rhythm
Peripheral artery disease – narrowing of the arteries in your arms and legs
CVD is often caused by atherosclerosis or plaque buildup in the arteries. Plaque is mainly made up of cholesterol and fat. Similar to how it’s harder for water to flow through a clogged pipe, plaque buildup makes it harder for blood to flow through your arteries to different parts of your body.
How is heart health and pregnancy related?
Pregnancy causes many changes to your body. It is a physically demanding time! During pregnancy, a person’s blood volume increases by 50%. The increased amount of blood means your heart is working harder: heart rate goes up, and the heart is physically pushing out more blood with each beat. During pregnancy, the risk of heart attacks go up 4 times and stay high for at least 12 weeks postpartum.
CVD is a leading cause of pregnancy-related deaths. As many as 2/3 of pregnancy-related CVD deaths are preventable. Maintaining good cardiovascular health is important before, during, and after pregnancy and can help prevent heart-related complications.
Part of why diagnosing CVD in pregnancy is difficult is because many symptoms overlap with normal pregnancy symptoms.
Some signs of a serious heart problem include:
Severe shortness of breath at rest, especially when laying down
Pounding, fast, or unusual heartbeat
Chest or belly pain
Bloody cough or coughing at night that won’t go away
Extreme swelling in the lower body (e.g. legs, feet)
Extreme tiredness
Feeling faint, woozy, weak, or unsteady
A headache that keeps getting worse
If you have any symptoms that concern you, let your care team know right away.
Risk factors for CVD in pregnancy include:
Substance abuse (including but not limited to opioids, alcohol, marijuana, cocaine, and amphetamines)
Hypertension (high blood pressure)
Diabetes
Pre-existing heart disease
Myocarditis (inflammation of the heart muscle)
Prior history of preeclampsia
HELLP syndrome (a life-threatening pregnancy complication related to pre-eclampsia)
Twin or other multiple pregnancies
BMI >30
>35 years old
First-degree relative who had gestational hypertension
Hypertensive disorders of pregnancy (HDP):
HDP is an umbrella term for conditions such as
chronic hypertension
gestational hypertension
preeclampsia/eclampsia
HELLP syndrome.
Hypertensive disorders of pregnancy are the second leading cause of maternal mortality after maternal hemorrhage and occur in about 10% pregnancies. They are associated with increased risk of CVD, hypertension, diabetes, and dyslipidemia for the baby later in life.
Adverse pregnancy outcomes related to cardiac disease:
Excess weight gain during pregnancy
Preeclampsia
Preterm birth
Intrauterine growth restriction/small for gestational age
Hemorrhage
Placental abruption
Gestational diabetes
Gestational hypertension
Progressive heart failure
Maternal or fetal death
Chronic hypertension, obesity, older age at pregnancy, diabetes, and tobacco use can increase individual risk for adverse pregnancy outcomes. These outcomes are associated with arrhythmia, heart failure, cardiomyopathy (disease of the heart muscle), vascular disorders (conditions that affect how the blood vessels work), coronary artery disease, stroke, chronic kidney disease.
High blood pressure in pregnancy, heart failure during pregnancy or within 5 months postpartum, diabetes can increase your risk of developing CVD later in life as well.
How Black women are particularly affected?
Barriers to care: missed opportunities to identify risk factors during prenatal care, gaps in high-risk intrapartum care, delays in recognizing symptoms
The 3.4 times increased risk of Black women dying from CVD-related pregnancy complications compared to White women is in part due to structural, institutional, and systemic barriers that result from racism.
Protect your heart! What you can do
Keep your prenatal and postpartum appointments!
Regularly getting checkups with your care team is an important way to optimize screening and to catch early symptoms of potential CVD or complications.
Make changes to your diet
Exercise
Stop smoking
Find ways to reduce stress
Get enough sleep every night
Breastfeeding
Low-dose aspirin
Explore the BWPC Community Health Library to learn more about conditions that relate to heart health and pregnancy.