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Women with high blood pressure in pregnancy, known as preeclampsia, or pregnancy-related diabetes were more likely to have cardiovascular disease risk factors at around 50, the British researchers found. The risk was greater with preeclampsia.
"For women, this study suggests that if they have experienced any of the pregnancy complications [evaluated], they may consider seeking advice regarding effective interventions and lifestyle changes in order to modify their CVD [cardiovascular disease] risk," said study leader Abigail Fraser, a research fellow at the University of Bristol School of Social and Community Medicine.
Moms-to-be with preeclampsia were 31 percent more likely to have risk factors for heart disease at around age 50 than those who had normal blood pressure during pregnancy. They tended to be heavier and have higher blood pressure and irregular blood sugar control than women with a healthy pregnancy.
For the study, published Feb. 20 in the journal Circulation, the researchers looked at the pregnancies of more than 3,400 women enrolled in the Avon Longitudinal Study of Parents and Children in the early 1990s.
Nearly 30 percent had one complication, and about 5 percent had two. Besides high blood pressure and diabetes, the researchers were interested in whether preterm delivery and babies born small or large for gestational age affected heart disease risk later.
After 18 years, they reassessed the women, who then averaged 48 years old. They used the Framingham prediction score, a respected measure, to evaluate their risk of getting cardiovascular disease in the next 10 years.
Giving birth to babies large for gestational age was linked with higher blood sugar and wider waists. Giving birth to babies small for gestational age and delivering before term was linked with higher blood pressure.
The findings make sense to Marie Frazzitta, a nurse practitioner and coordinator of the North Shore University Hospital's Center for Diabetes in Pregnancy, Manhasset, N.Y.
"Pregnancy is like a stress test that can identify what chronic conditions a woman may be susceptible to later in life," she explained.
Dr. Tara Narula, a cardiologist at Lenox Hill Hospital, New York City, agreed. "Pregnancy may be a unique point in time where physicians get a window into a woman's future risk for cardiovascular disease," she said. Factors such as preterm delivery and baby's size may help predict a woman's long term risk of developing cardiovascular disease or risk factors, she said.
"If physicians can use the information gained during pregnancy to appropriately manage a woman's risk, we may be able to limit the number of deaths caused by CVD, the number one killer of American women," Narula said.
She said the study provides good information, but is limited in that "the follow-up occurred at an age in women (younger than 50) when CVD events are low in general."
The study, which builds on previous research, was funded by the U.S. National Institute of Diabetes and Digestive and Kidney Disease, the British Heart Association and Wellcome Trust.
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