Thinking of starting a family? Start getting your heart in shape. New research suggests that how healthy a woman’s heart is before conception affects outcomes in her pregnancy.
Study author Dr. Sadiya Khan said the findings make a case for more comprehensive heart assessments prior to pregnancy rather than focusing on isolated individual risk factors, such as high blood pressure (“hypertension”) or body mass index (an estimate of body fat based on height and weight).
“In reality not all pregnancies are planned, but ideally we would evaluate women well in advance of becoming pregnant so there is time to optimize their health,” said Khan, an assistant professor of cardiology at Northwestern University Feinberg School of Medicine, in Chicago.
“We also need to shift our focus towards prioritizing and promoting women’s health as a society — so instead of just identifying hypertension, we prevent blood pressure from becoming elevated,” Khan suggested in a news release from the European Society of Cardiology.
The study, which included more than 18.6 million pregnancies, found a strong relationship between pregnancy outcomes and women’s heart health, including four risk factors for heart disease. Those risk factors are unhealthy body weight, smoking, high blood pressure and diabetes.
For the study, the researchers analyzed U.S. government data on live births and fetal deaths after 20 weeks’ gestation. Individual-level data was pooled from births to women aged 15 to 44 years from 2014 to 2018.
More than 60% of women had one or more pre-pregnancy heart disease risk factor, with 52% having one and 7% having two, the investigators found.
Compared to women with no risk factors, those with all four had about six times the risk for intensive care unit (ICU) admission, about four times the risk for preterm birth, almost three times the risk for low birth weight and almost nine times the risk for fetal death.
In addition, the findings showed that each risk factor increased the likelihood of adverse outcomes. Compared to women with no risk factors, having one risk factor raised the odds for a pregnant woman needing ICU care by 12%, having two risk factors bumped up the risk by 86%, having three risk factors more than quadrupled the risk, and having four raised it nearly six-fold.
The researchers repeated the analysis in women having their first baby with consistent results.
“Individual cardiovascular risk factors, such as obesity and hypertension, present before pregnancy have been associated with poor outcomes for both mother and baby,” Khan said. “These data underscore that improving overall heart health before pregnancy needs to be a priority.”
The findings were published July 21 in the European Journal of Preventive Cardiology.
The U.S. Department of Health and Human Services has more on keeping your heart healthy.
SOURCE: European Society of Cardiology, news release, July 20, 2021