News from the American Heart Association
MONDAY, February 13, 2023 (American Heart Association News) — A woman’s pre-pregnancy heart health has a powerful impact on her risk of pregnancy-related complications and the long-term cardiovascular health of both mother and child that calls for greater attention to it Theme.
Improving maternal heart health at this critical time could help break the generational cycle of poor cardiovascular health, which has become a growing problem in the United States, particularly among women whose health is compromised by structural racism and other adverse social factors, according to a new American Heart conditions, the association’s scientific statement released in circulation on Monday.
“If you optimize the mother’s health before pregnancy, it will optimize her health during pregnancy, which will impact the health of the child later,” said Dr. Holly Gooding, Vice Chair of the Statements Writing Committee. Gooding is Medical Director of Adolescent Medicine at Children’s Healthcare of Atlanta and Associate Professor in the Department of Pediatrics at Emory University in Atlanta.
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Cardiovascular disease is responsible for more than 1 in 4 pregnancy-related deaths in the US, and rates of pregnancy-related complications have increased, according to the report. Almost one in five pregnancies is complicated by high blood pressure, gestational diabetes, premature birth or low birth weight. Hypertensive diseases such as preeclampsia and eclampsia have almost doubled in the last decade. These types of adverse pregnancy outcomes have been shown to increase the risk of cardiovascular disease later in life for both mother and child.
Studies show that black women are disproportionately affected. As the number of pregnancy-related deaths in the US has increased, black women are three times more likely to die from pregnancy-related complications than white women.
“This statement examines upstream what the potential contributors to this increasing burden may be,” said Dr. Sadiya Khan, chair of the writing committee and assistant professor of medicine at Northwestern University’s Feinberg School of Medicine in Chicago.
The new AHA report summarizes current evidence linking a woman’s heart risk factors before and between pregnancies to pregnancy-related complications and subsequent maternal and fetal cardiovascular health. It calls for research into other ways to improve women’s health during the childbearing years, starting in early childhood. And it emphasizes the need for changes at the policy level to address structural racism and other adverse social factors that create barriers to better maternal health.
“Finding ways to intervene and promote health equitably is crucial,” Khan said.
A 2021 scientific statement from the AHA looked at cardiovascular health in pregnant and postpartum women. The new statement focuses on a woman’s health before and between pregnancies.
Because a woman can become pregnant unexpectedly, the writing committee chose to define pre-pregnancy broadly, as at any time during her childbearing years, Gooding said. For most women, this period is between 15 and 44 years, although it varies from person to person.
“We intentionally avoided defining it because that’s something that further studies need to address,” Khan said. “When is the appropriate time before pregnancy to intervene? At the population and public health level, we want to look at this from a life-course perspective and focus on prioritizing cardiovascular health as a person reaches reproductive age.”
The best way to achieve good heart health — at any age — is to follow the key health measures and behaviors outlined in AHA’s Life’s Essential 8, Khan said. These include not smoking, getting enough sleep and physical activity, maintaining a healthy weight, eating a healthy diet, and controlling blood pressure, blood sugar, and cholesterol levels.
But responsibility for helping women achieve those goals must include health professionals and policymakers, she said. It is crucial to ensure that women have access to primary care throughout their lives, including before they wish to become pregnant, as well as access to insurance to cover contraception and pregnancy-related care. It’s also important to have enough doctors to see them and make sure their cardiovascular risk factors are monitored.
“It’s a natural conclusion to say that we should all make cardiovascular health a priority, but it’s important that we don’t just put the responsibility on individuals,” Khan said.
The statement said future research should focus on finding evidence-based strategies to reduce maternal health risks and how such strategies might reduce the burden of cardiovascular disease more broadly.
Khan said some of that work has already begun.
She is a fellow researcher in the AHA’s Health Equity Research Network on disparities in maternal and child health outcomes, which seeks innovative and cost-effective strategies to improve access to pre, during, and post-pregnancy health information and care for Black and Native American women and people who live in rural areas.
In 2021, the Federal Office for Minority Health launched a free e-learning program to build the knowledge and skills of maternal health professionals in relation to cultural competence. And last year, the White House released a Maternal Health Blueprint, which includes efforts to strengthen economic and social support for women before, during and after pregnancy. It also includes programs to lower high blood pressure for Native Americans and veterans of childbearing age.
American Heart Association News reports on heart and brain health. Not all views expressed in this story reflect the official position of the American Heart Association. Copyright is owned by the American Heart Association, Inc. and all rights are reserved. If you have any questions or comments about this story, please email [email protected]
By Laura Williamson, News of the American Heart Association