Link Between Pregnancy Complications and Heart Disease

by Nina

The Kiss by Mary Cassatt

Baxter and I recently read an extraordinary 50-year study Pregnancy Complications and Cardiovascular Disease Death: Fifty-Year Follow-Up of the Child Health and Development Studies Pregnancy Cohort  that was conducted on nearly 15,000 women who became pregnant from 1958 to 1967. The study noted which of the pregnant women had pregnancy complications and then followed all the women through 2011. For those women who had pregnancy complications, the study found a link to death from heart disease before age 60.

We wanted to let you know about this study because of course some of our readers will fall into this category of having had pregnancy complications. We don’t want you to panic, of course. We just want you to be aware of the link between these conditions, and hopefully take a few preventative steps. 

So today I’ll start by telling you about which complications are linked to heart disease, and why. Then I’ll say something about what you should do if you are at risk (Or, what you should help a relative or friend do if she is at risk.)

Which Pregnancy Complications are Linked to Heart Disease?

Pregnancy complications that raised the risk of death from heart disease included:

• High blood pressure before or starting during pregnancy (preeclampsia) 
• Low-birth-weight child
• Early delivery
• A drop in the ability of red blood cells to carry oxygen
• High sugar levels in the urine

According to a co-author of the study, Barbara A. Cohn, PhD, director of the Child Health and Development Studies at the Public Health Institute, all these complications increased the risk of dying from heart disease before 60. Having more than one complication raised the risk even more. Depending on the complication, and the number of them, the risk of death increased by nearly two to seven times. The study concluded:

"The presence of pre- existing hypertension coupled with pre-eclampsia, preterm birth, or SGA birth, strongly predict CVD death. Furthermore, we found that early-onset pre-eclampsia predicts death before age 60."

Why is there a Link between these Complications and Heart Disease?

Apparently the complications themselves aren’t the cause of increased risk of heart disease. Instead, the complications may be a predictor of how well a woman's cardiovascular system can adjust to the demands of pregnancy. So the pregnancy functions as a metabolic stress test for identifying women who are at higher risk of cardiovascular disease later in life.

When you are pregnant, your heart has to work harder to pump enough blood throughout your body and to your unborn baby, as a your blood volume doubles during pregnancy. So pregnancy provides a picture of how well your body is functioning, with complications and preeclampsia showing that a woman’s heart and blood vessels already have problems. While it takes decades for heart disease to develop, these conditions lay the groundwork.

What Should You do if You fall into this Category?

The authors of the study provided advice for doctors rather than patients:

"Physicians should provide early, prompt surveillance and intervention for women with these high-risk pregnancy complications."

and

"We observed combinations of pregnancy complications that predict high risk of death and two new risk markers, glycosuria and hemoglobin decline. 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."

If you are currently pregnant and experiencing any of these complications, please alert your obstetrician to this study so the doctor can take appropriate actions. 

If you previously experienced any of these complications, take this information to your doctor, whether that is your internist or OB/GYN, and discuss what is the best approach for you. In the meantime, you can support the medical monitoring or treatment you are receiving from your doctor with a yoga practice focused cardiovascular health.

Start by reading our post Heart Health and Yoga for some background information. Then you can check out our yoga sequences for heart health, which are both short and accessible practices. 

The Inverted Heart Health Sequence includes inverted poses because they can have several immediate and long-term influences on your heart and circulatory system. Inversions put your body in a position to take advantage of gravity to assist in venous return to your heart—you flip upside down and gravity pulls the blood back toward your heart and head! They can also have a quieting effect on your nervous system, encouraging a shift from Fight or Flight mode to Rest and Digest mode. Your heart muscle needs both exercise and rest, so a good combination of effort and relaxation in your practice will give your heart a more balanced experience.

The Cardiovascular Heart Health Sequence includes:

Dynamic Yoga Sequences. Linked sequence of poses that move fairly quickly, such as Sun Salutations, gradually warm up your body and your cardiovascular system, both strengthening and stretching the muscles and connective tissue that your body’s blood vessels pass through, both exercising your heart and encouraging more efficient flow through the piping of your system.

Static Poses. Poses that you hold for longer periods increase what is known as the “work load” of your heart, providing a different kind of exercise and challenge for your heart. Those with high blood pressure and diabetes will have to approach these poses with caution and work into the holds very gradually, preferably under the guidance of an experienced teacher.

Gentle Inversions and Restorative Poses. These poses quiet and rest your cardiovascular system and your heart, which is equally important to testing and stressing your system. They allow your heart and nervous system to quiet, and as a result can nicely lower your blood pressure, heart rate and breathing rate.

Pranayama and Meditation Practices. These practices support the effects of the inversions and restorative poses.

If chronic stress is a problem for you, see The Relaxation Response and Yoga for an overview of how yoga helps with stress and a list of techniques to choose from. We also have many posts on insomnia (see Five Tips for Better Sleep, for example). Finally, if you’re struggling with poor eating habits, see Yoga for Healthy Eating. 

See webmd.com for further information. (We can't give you access to the full original study, which Brad obtained for us, but the abstract is at Pregnancy Complications and Cardiovascular Disease Death: Fifty-Year Follow-Up of the Child Health and Development Studies Pregnancy Cohort.)

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