Sara Szal MD and Cynthia Thurlow, NP
For nine months of pregnancy, your body runs the most demanding physiological experiment it will ever run. Your heart output rises by 30 to 50 percent. Your blood volume expands. Your pancreas, kidneys, and vascular system get pushed to their limits. Nothing else in a woman’s life will stress every system at once quite like this.
And when something breaks under that load, it’s telling you something important, not just about that pregnancy, but about the next 40 years.
It’s the stress test of pregnancy, and a lot of us fail it.
If you’re had any of the following, your future cardiovascular risk is not the same as a woman who didn’t:
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a hypertensive disorder of pregnancy, preeclampsia, eclampsia, or gestational hypertension
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gestational diabetes
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preterm delivery
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a small-for-gestational-age or low-birth-weight infant
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placental abruption
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pregnancy loss
These aren’t vague risk factors. The American Heart Association names all six as independent predictors of future cardiovascular disease, separate from your cholesterol, weight, or family history. Preeclampsia along carries 3X the risk. Gestational diabetes raises it by two-thirds and increases your risk of type 2 diabetes by tenfold. Preterm delivery doubles it.
Your OB delivered the baby, and almost nobody delivers the cardiac risk assessment.
If you’re had any of the conditions above or you have autoimmune disease, that’s your cue for an early cardiometabolic workup, blood pressure tracking, an advanced lipid panel, a fasting glucose or A1C, and a conversation with your doctor about imaging like a coronary artery calcium score or CT angiogram, or the other 11 tests mentioned in this recent post.
Tell us: Did you have any of these during pregnancy? Has anyone ever connected it to your heart health since?
