Women who experience complications during pregnancy have a higher long-term risk of developing ischemic heart disease, a heart disease, according to recent Swedish research.
- Ischemic heart disease is a disease characterized by an insufficient quantity of blood transported to the heart muscle (the myocardium).
- It causes a reduction in oxygen supply to heart cells.
- Cardiovascular diseases (13.7% of deaths) are the leading cause of death for women during pregnancy or up to a year later.
Women who experience any of the five major complications of pregnancy, including preterm birth and pre-eclampsia, have a higher risk of ischemic heart disease up to 40 years after childbirth, according to a study. new study published on February 1 in the British Medical Journal.
To arrive at these results, the team of researchers behind the study, based in the United States and Sweden, examined the links between five pregnancy complications and the long-term risks of ischemic heart disease in mothers. . They retrieved data from 2,195,266 Swedish women, with an average age of 27 and no history of heart disease, who gave birth to a single child between 1973 and 2015.
Pregnancy: what are the 5 main complications?
Using national medical records, the researchers then followed the cases of ischemic heart disease from the date of delivery to December 2018, with an average length of follow-up of 25 years, going up to a maximum of 46 years. The top five pregnancy complications according to them were preterm birth (less than 37 weeks gestation), small size for gestational age at birth (SGA), pre-eclampsia, other hypertensive disorders of pregnancy, and gestational diabetes.
Other important factors were taken into account, such as mother’s age, number of children, level of education, income, body mass index, smoking status and history of hypertension high blood pressure, diabetes or hypercholesterolemia. Overall, ischemic heart disease was diagnosed in 83,881 women (3.8%), with an average age of 58 years. The results show that women who experienced any of the five main pregnancy complications had a higher risk of ischemic heart disease.
Ischemic heart disease: a risk factor 1 to 2.3 times higher
Thus, over the 10 years following childbirth, rates of ischemic heart disease doubled in women with other hypertensive disorders of pregnancy (46 additional cases per 100,000 people), 1.7 times in those who gave birth before term. (19 additional cases per 100,000), 1.5 times in those with pre-eclampsia (12 additional cases), 1.3 times in those with gestational diabetes and 1.1 times in those who gave birth with SGA, after adjustment for all other factors.
Women who experienced multiple pregnancy complications showed an even greater increase in risk. Over the 10 years postpartum, the rates of ischemic heart disease with 1, 2, or 3 or more complications were 1.3 times, 1.8 times, and 2.3 times, respectively (20, 34, and 58 cases per 100,000) higher than normal. Most of these rates declined over time, but remained significantly above normal (1.1 to 1.5 times) even 30 to 46 years postpartum, and were only partially explained by genetic or environmental factors shared within families.
Encourage risk prevention after a pregnancy complication
Remember that this is only an observational study (so it cannot establish a causal relationship), with certain limitations (for example, the researchers cannot exclude the possibility that ischemic heart disease was under-reported or that maternal smoking, obesity or other risk factors during pregnancy may have affected their results).
Nevertheless, the large sample size and extensive data with long-term follow-up lead researchers to argue that all major complications during pregnancy should be recognized as lifelong risk factors for ischemic heart disease. “Women with pregnancy complications should be considered for early preventive evaluation and long-term risk reduction to help prevent the development of ischemic heart disease”they conclude.