Pregnant women’s heart health needs improvement

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The first study of cardiovascular health in pregnant women in the U.S. found it is suboptimal and needs improvement, reports Northwestern Medicine. 

Fewer than one in 10 pregnant women had “favorable” cardiovascular health, according to the study. Healthy diet and optimal physical activity were especially rare in pregnant women.

“Knowing the heart health of women during pregnancy is important for planning strategies to improve it and potentially improve health outcomes for the mother and child,” said Dr. Amanda Marma Perak, an assistant professor of pediatrics and preventive medicine at Northwestern University Feinberg School of medicine and a preventive cardiologist at Ann & Robert Lurie Children’s Hospital of Chicago.

Pregnancy acts as a “stress test” for the mother, revealing her underlying risk for later cardiovascular disease. It’s also a critical period for determining the baby’s later heart health.

The study found 4.6% of pregnant women had high cardiovascular health, 60.6% had moderate cardiovascular health and 34.8% had low cardiovascular health. 

In the study, cardiovascular health was measured by diet, exercise, nonsmoking, body mass index, blood pressure, total cholesterol and blood glucose.

The study was published Feb.17 in the Journal of the American Heart Association.

The individual components of cardiovascular health measured during pregnancy have previously been associated with pregnancy outcomes as well as longer-term maternal and offspring health.

“Pregnant women should work with their primary care doctors or obstetrician/gynecologists, or both, to optimize their cardiovascular health levels before, during and after pregnancy,” Perak said. “This means having a healthy diet, being physically active, avoiding smoking, having a healthy body weight and optimal levels of blood pressure, cholesterol and blood sugar."  

“Healthy diet and optimal physical activity were especially rare in pregnant women, so these two behaviors would be a great place to start,” Perak added. 

The study also found cardiovascular health levels were worse in pregnant women who were younger (age 20 to 24 years compared to 35 to 44 years) or who were non-Hispanic black (versus non-Hispanic white or Hispanic). These subgroups may need special attention, Perak said.

The study was conducted using data from the National Health and Nutrition Examination Surveys (NHANES) 1999 to 2014 for 1,117 pregnant and 8,200 nonpregnant women, aged 20 to 44 years. NHANES provides detailed health information for a nationally representative sample of individuals from the U.S. Researchers examined CVH levels among pregnant women and also compared them to CVH levels in non-pregnant women, controlling for things like the mother's age, sex, race or ethnicity and socioeconomic status.

Other Northwestern authors are: Dr. Hongyan Ning, Dr. Sadiya Khan, Linda Van Horn, Dr. William Grobman and Dr. Donald Lloyd-Jones. 

The study was funded in part by a National Institutes of Health (NIH)/National Heart, Lung, and Blood Institute training grant T32HL069771 and award K23HL145101, National Center for Advancing Translational Sciences grant KL2TR001424, Northwestern University Feinberg School of Medicine and an award from the American Heart Association.