Pregnancy Complications Raise Heart Disease Risk

A new study suggests a high correlation between women who experienced complications during pregnancy and those facing death from heart disease later in life.

Researchers at the Public Health Institute (PHI; Oakland, CA, USA; Berkeley, CA) conducted a study involving 14,062 women, examining pregnancy events over five decades (1959–1967) and CVD death through 2011 in order to identify the combination of pregnancy complications that predict risk for cardiovascular disease (CVD) death, and how these risk changes with age. CVD death was determined by linkage to California Vital Statistics and to the US National Death Index. The women were a median age of 26 years at enrollment and 66 years old in 2011.

The results showed that delivery of a small-for-gestation or preterm infant and early-onset preeclampsia (by week 34) significantly predicted premature CVD death. Preterm birth combined with hemorrhage, gestational hypertension, or pre-existing hypertension identified women with a 4- to 7-fold increased risk of CVD death. And preeclampsia in combination with pre-existing hypertension conferred a significant 6-fold risk, compared to a 4-fold risk for pre-existing hypertension alone.

The study also established two new conditions that could indicate future heart disease: glycosuria, or high levels of sugar in urine, entailed a 4.2-times greater risk, while hemoglobin decline over the second and third trimesters increased CVD risk of 1.7 times. Overall, 6%–8% of women developed gestational hypertension; 5%–8% of women developed preeclampsia; and 2%–5% of the women developed gestational diabetes. The study was published on September 21, 2015, in Circulation.

“We observed combinations of pregnancy complications that predict high risk of death and two new risk markers, glycosuria and hemoglobin decline,” concluded study authors Piera Cirillo, MPH, and Barbara Cohn, PhD, of the PHI Child Health and Development Studies (CHDS) unit. “Obstetricians serve as primary care physicians for many young women and can readily use these complications to identify high-risk women to implement early prevention.”

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