Women who faced pregnancy complications or those with poor heart health after pregnancy are at a significantly higher risk of developing cardiovascular disease later in life, a study has revealed. However, researchers also found that maintaining or improving cardiovascular health through a healthy lifestyle could cut the risk.
"Previous studies have shown that women with a history of adverse pregnancy outcomes tend to have a higher risk of developing cardiovascular disease later in life. However, it is unknown how much of this increased cardiovascular disease risk can be potentially modified by healthy lifestyle behaviors," lead study author Dr. Frank Qian said in a news release.
The researchers used data from the UK Biobank with health records of about 500,000 adults, including data from 2,263 women with a prior diagnosis of adverse pregnancy outcomes and 107,260 women with no history of complications during pregnancy. The study investigated the relationship between Life's Essential 8 scores and the risk of heart disease in participants, including both those who experienced complications and those who did not.
The study took into account pregnancy complications, including placental abruption, gestational diabetes, small size for gestational age, pre-term birth, and hypertensive disorders of pregnancy such as preeclampsia or gestational hypertension.
Life's Essential 8 are important factors that help improve heart health which include: eating well, staying active, quitting smoking, getting healthy sleep, and keeping weight, cholesterol, blood sugar, and blood pressure in check.
Based on adherence to these factors, cardiovascular health scores were calculated from 0 to 100, with higher scores indicating better cardiovascular health.
None of the participants had heart disease at the beginning of the study. However, after an average of 13.5 years of follow-up, 197 cardiovascular disease events were reported among the group with a history of adverse pregnancy outcomes.
Women who had better cardiovascular health measures post-pregnancy, or those with Life's Essential 8 scores higher than 76, showed a 57% lower risk of developing cardiovascular disease compared to women with scores below 67. Women with medium and low Life's Essential 8 scores (68.2 to 77.5 and below 68.1, respectively) had a higher risk for heart disease — 25% and 81%, respectively. This is regardless of whether they had a history of adverse pregnancy outcomes or not.
"Women who had complications during pregnancy and poor cardiovascular health scores after pregnancy had a 148% increase in the risk of developing cardiovascular disease. Among women with a history of pregnancy complications, those who achieved or maintained high heart health after pregnancy were at a similar risk for heart disease as women without adverse pregnancy outcomes and good cardiovascular health," the news release stated.
There are two main limitations of the study. Since it is an observational analysis, the findings do not confirm cause and effect. More than 94% of the study population from the UK Biobank self-identified as white race, so the findings may not be generalizable to people of other races or ethnicities.
"We were most surprised to find that women who had a history of pregnancy complications and were able to achieve and maintain a high level of cardiovascular health after pregnancy significantly reduced their risk of future cardiovascular disease. They essentially had an equivalent CVD risk to women without no history of adverse pregnancy outcomes who also had high cardiovascular health," Qian said.
"These findings are important for clinical practice as well as designing public health interventions and policies. We need to identify high-risk women and focus on ensuring they have access to lifestyle or treatment to reduce their long-term risk of cardiovascular disease," the researcher added.
