Rising obesity contributes to increased risk of cardiovascular disease during and after pregnancy, experts warn.
Obese people are more at risk for potentially fatal pregnancy complications such as diabetes, hypertension and preeclampsia. Those conditions increase the risk of heart disease and stroke, according to a recent report from the American Heart Association — a major concern, since heart disease is already the leading cause of pregnancy-related deaths.
“When comparing heart disease and poor pregnancy outcomes in women, we find that obesity is a link,” Dr. Sadiya Khan, lead author of the paper and assistant professor of medicine at Northwestern University Feinberg School of Medicine, told ABC News.
Obesity is an inflammatory condition that can damage blood vessels and make cells resistant to insulin, experts say. This ultimately contributes to the onset of diseases such as high blood pressure, high cholesterol and diabetes.
Obesity mixed with the expected hormonal changes during pregnancy creates a perfect storm that can harm the pregnant woman and the baby, says Khan. For example, the combination of changes from obesity and changes from pregnancy can lead to gestational diabetes, she says.
Obesity is also linked to abnormal development of the placenta, research shows. That can increase the risk of preeclampsia, a complication characterized by high blood pressure and organ damage.
Regardless of weight, high blood pressure or diabetes during pregnancy may go away after delivery. However, people who had these conditions during pregnancy are still more likely to develop heart disease in their lifetime, research shows.
A study published earlier this month found that pregnant people with high blood pressure, diabetes, preeclampsia, a premature birth or a small baby were at risk of developing heart disease for up to 46 years after giving birth.
“There are two possible reasons that these complications in pregnancy cause long-term heart disease,” Khan said. “Either the complication itself directly causes heart disease, or the complication is a reflection of a person’s underlying risk.”
Not everyone is at the same risk. Black women have a disproportionate risk of complications during pregnancy, such as preeclampsia. Black women also have significantly higher pregnancy-related death rates than white women in the United States, according to data from the Centers for Disease Control and Prevention.
“There is a growing awareness of the black maternal mortality crisis,” Dr. Natalie Bello, director of hypertension research at the Smidt Heart Institute at Cedars-Sinai Medical Center and co-chair of the American College of Cardiology Reproductive and Cardio-Obstetrics Section, told ABC News. “We need to address the issues around social and systemic barriers these women face.”
Screening and treating people for heart complications during pregnancy — whether they’re obese or not — can help reduce risks in the long run, Bello says. In addition, anyone who has a complication during pregnancy should be checked for heart disease, she says.
“Pregnancy may be the only time someone gets medical care,” Bello said. “At that point, they may not realize that they carry a high risk, such as obesity, for heart disease and complications during their pregnancy, so it’s best to get screened early in life to keep them safe during pregnancy and throughout their entire life to protect for them and their.” family health.”
Since heart disease is the leading cause of death in women year after year, experts agree that lifestyle intervention throughout their lifespan should be the main driver to reduce these unfavorable metrics.
“Blood pressure screening, a healthy weight, good sleep hygiene, are some examples someone can take to make sure they’re in the right place regarding their heart health,” Bello said. “The next steps would be to monitor how to maintain these healthy parameters so that they can go into their pregnancy heart healthy for themselves and their baby.”
Lily Nedda Dastmalchi, DO, MA, is a cardiologist at Temple University Hospital and a contributor to the ABC News Medical Unit.