When you’re pregnant, there are so many changes. Your body doesn’t feel like your own anymore. There’s heartburn, hair growth, hair loss, gestational diabetes and so much more—including things I didn’t know a lot about or think to worry about.
I remember when I was pregnant, I had heard of people having preeclampsia but didn’t really know what it was. I also didn’t think about how pregnancy was affecting my heart, but I should have. For American Heart Month, I reached out to Odayme Quesada, MD, medical director of The Christ Hospital Women's Heart Center, to learn more about how pregnancy affects the heart.
Pregnancy — Women’s first stress test
Dr. Quesada said, “Pregnancy has been described as a woman's first stress test. During pregnancy, the heart works up to 40% harder than usual to pump blood to your body and baby, making it extremely important to have a healthy heart. Women with healthy hearts are able to adapt to the high demands of pregnancy on the heart. But women with underlying abnormalities are more likely to develop adverse pregnancy outcomes such as preeclampsia or preterm delivery and are thought to have failed their stress test because they are at higher risk of developing heart disease later in life and at an earlier age.”
When you’re pregnant, you should be paying attention to your heart health, including watching for signs and symptoms of gestational hypertension or preeclampsia, which include swelling of the feet and high blood pressure.
When I was pregnant, I remember my feet swelling all the time. I should have probably paid more attention to that. Dr. Quesada also said to watch for signs and symptoms of heart failure, such as shortness of breath, swelling of the feet, or, worse, shortness of breath when trying to lay down.
Swelling and shortness of breath may be difficult to tell apart from normal pregnancy, so it is important to consult your OB/GYN for guidance. It’s important to your pregnancy heart health to know your numbers! You should have regular checkups to identify risk factors such as high blood pressure, diabetes and cholesterol problems before pregnancy.
If you have a current heart condition, plan to meet with a cardiologist or cardio-obstetric team if you are planning to get pregnant. And remember to stay active, eat a balanced diet, get enough sleep, and consider practicing mindfulness during the pregnancy and quit smoking if you smoke.
Risk for preeclampsia
It's possible you could develop preeclampsia while you’re pregnant. Dr. Quesada says preeclampsia is new hypertension (high blood pressure) and evidence of damage to other organs, typically the kidneys, which is why many women have more protein in their urine after 20 weeks of pregnancy.
Every woman is at risk for preeclampsia, but women with risk factors like high cholesterol, diabetes, smoking and hypertension are at a higher risk. Moms that use in vitro fertilization, or are older when they become pregnant, are also at higher risk.
Preeclampsia, if not recognized and treated, can lead to eclampsia, which causes seizures and is very dangerous. Diagnosis for preeclampsia includes high blood pressure of >140/90, urine and blood tests. When it comes to treatment, an aspirin is given to patients at high risk to decrease the risk of developing preeclampsia.
Once you have been diagnosed with preeclampsia, blood pressure is managed with medications, and you are started on intravenous medication called magnesium to decrease the risk of eclampsia, which is life threatening to mom and baby.
The Christ Hospital post-pregnancy study
Dr. Quesada has some exciting news to share.
The Christ Hospital is currently doing a post-pregnancy study when it comes heart health. She was awarded a grant from the National Institutes of Health to study the link between hypertensive disorders of pregnancy (such as preeclampsia) and heart disease later in life.
The study involves one visit to The Christ Hospital. The visit lasts about four hours and involves questions about your past medical and pregnancy history, a collection of blood and urine samples, non-invasive tests to measure blood pressure and how well blood moves through your veins, an electrocardiogram (often referred to as an ECG or EKG) and an MRI of your heart.
There is also an electronic questionnaire that The Christ Hospital asks participants to complete at that visit and once a year for the duration of the study. They are looking for women who are at least 18 years old and have given birth in the last 2 to 10 years.
They are recruiting both women who had preeclampsia during pregnancy and women who had healthy pregnancies to serve as a comparison group. Women who are currently pregnant or breastfeeding, have certain ongoing medical conditions like diabetes or kidney disease or are not able to have an MRI are not eligible to participate.
More information about the study can be found on The Women’s Heart Center website under the Current Studies section of the Research tab. From there you can view the full study flyer for additional study details and take an online risk assessment to see if you may qualify to be a study participant.