Pregnancy is often referred to as the first significant stress test for the body. The increase in blood volume during pregnancy, labour and delivery affect blood pressure, forcing the heart to work harder.
During pregnancy women may develop certain conditions that put them at risk of heart conditions and stroke. There are disorders related to high blood pressure in pregnancy, often referred to as hypertensive disorders in pregnancy. These pregnancy disorders are diagnosed based on high blood pressure readings in a woman who previously experienced normal blood pressure:
- chronic high blood pressure: before 20 weeks,
- gestational high blood pressure: after 20 weeks,
- preeclampsia: high blood pressure, presence of protein in urine, headaches, changes in vision,
- eclampsia: when a pregnant or newly postpartum woman experiences seizures or loss of consciousness, typically following signs of preeclampsia.
Gestational diabetes can increase the risk of the mother and baby developing diabetes later in life. While a woman is pregnant, their body must produce extra insulin because increasing levels of pregnancy hormones interfere with the body's ability to use insulin efficiently. If the woman's body can't produce the additional insulin sufficiently, their blood sugar levels may rise, causing gestational diabetes. Diabetes is a risk factor for heart conditions and stroke.
Preterm birth, abruption and infertility are additional risk factors associated with the risk of future heart conditions, such as premature building up of plaque in the arteries, arrhythmia, and heart failure.
Pregnancy-related stroke is relatively rare, but it can happen, and the highest risk period is during birth and after delivery. A high-risk time is during childbirth and the first few months after birth. It is usually the result of an underlying problem such as a pre-existing blood vessel malformation or eclampsia.
Fertility treatments including in-vitro fertilization creates increased hormone levels that may put women at higher risk for heart conditions and stroke. This is an active research area, the evidence is still emerging, and no consensus exists.
Complications that can arise from pregnancy are risk factors for developing heart conditions and stroke later in life.
Most pregnant women get regular checkups which presents a unique opportunity to identify pre-existing or pregnancy-related conditions that increase risk of developing heart conditions or stroke later in life. Counselling about the risks of heart conditions and stroke needs to be routinely integrated into these checkups.
