Pregnancy Complications May Signal Heart Disease Risk Later in Life

Certain complications during pregnancy may increase a woman's risk of dying from heart disease later in life, according to a new analysis.

That increased risk can be dramatic, more than 7-fold, if a woman experiences combinations of problems.

The analysis is from Oakland's Public Health Institute and was published Monday in the American Heart Association journal, Circulation.

Heart disease is the number one killer of women in America, responsible for one in every four deaths among women, according to the Centers for Disease Control.

While doctors have long known that pregnancy puts real stress on a woman's cardiovascular system, this study confirms and quantifies some known risks and identifies new ones.

The women followed and assessed were part of a unique group of more than 15,000 pregnant women who enrolled in the Oakland metropolitan area Child Health and Development Studies between 1959 and 1967. Researchers have been following these women for decades since.

The 7.1 times increased risk of death from heart disease happened in women who had pre-pregnancy or early-pregnancy high blood pressure in combination with a pre-term delivery of the baby.

If a woman had pre-existing high blood pressure and pre-eclampsia, which is characterized by high blood pressure after 20 weeks of pregnancy and protein in the urine, her risk of later heart disease death increased 5.6 times.

Senior author Barbara Cohn with Oakland's Public Health Institute said she was surprised by the some of the findings.

"Knowing additional information about the combinations of complications ... led to higher risk of cardiovascular disease than we expected.

Cohn and her colleagues also identified statistically significant differences for African-American women. They made up 22 percent of the enrollees in the study, but were 1.7 times more likely to die of heart disease, if they developed high blood pressure after 20 weeks of pregnancy. Women in other ethnic groups -- Hispanic, Asian, and Caucasian -- did not appear to be at significant increased risk from this development.

Cohn argued that doctors could save lives simply by taking a woman's pregnancy history.

"If she has had these complications, (doctors) can begin surveillance early, recommend prevention measures that the patient can take to address factors they can control," Cohn said. "It's really not expensive to get this history. It doesn't require an intervention like a blood test or a special medical test.

UC San Francisco professor Dr. Rita Redberg, who directs women's cardiovascular services, was not involved in the study. In an interview with HealthDay she said that the study reveals an opportunity to identify the at-risk population at a younger age.

"Obviously, we're catching women younger when we're doing it during pregnancy," Redberg said. "While it's never too late, we like to start young."