The study showed that the obesity plays a larger role than pregnancy complications such as preeclampsia and gestational diabetes increasing risk of developing heart disease later in life.
“We demonstrate, for the first time, that adverse pregnancy outcomes are primarily indicators–and not the root cause–of future heart health,” said corresponding author Sadiya Khan, the Magerstadt Professor of Cardiovascular Epidemiology at Northwestern University Feinberg School of Medicine.
“This means that pregnancy just reveals the risk for heart disease that is already there,” Khan added.
The researchers followed 4,216 first-time pregnant individuals from the early stages of their pregnancy to an average of 3.7 years postpartum.
At the early-pregnancy first study visit, the average maternal age was 27 years old, and 53 per centhad a normal body mass index (BMI), 25 per centwere overweight and 22 per centhad obesity.
The findings, published in the journal Circulation Research, showed that compared to those with a normal BMI in early pregnancy, individuals with overweight or obese BMI had a higher risk of developing hypertensive disorders of pregnancy.
In the study, the scientists wanted to better understand the associations among maternal obesity, hypertensive disorders of pregnancy and other adverse pregnancy outcomes, and cardiovascular health several years after delivery.
“Our hypothesis was that it may be that the pregnancy complications are unmasking these things since, as we know, pregnancy is a natural stress test for the heart,” Khan said. “These findings are important because if pre-pregnancy obesity is the culprit or cause of risk, we should be targeting this with interventions.
“We don’t want to just wait until people have these cardiovascular events; we want to stop them from happening,” Khan said.
A major throughline of Khan’s research is the idea of the “Zero trimester,” or pre-pregnancy health. By improving health during this critical time in an individual’s life, they can improve outcomes for not only their pregnancy and baby but for their personal long-term health, Khan said.
However, it can be difficult to target people before becoming pregnant, Khan said. So, early in the pregnancy may be an opportune time to counsel on heart-healthy habits like diet and exercise when people are more likely to be interacting with clinicians during prenatal visits.
“We definitely do not want to recommend weight loss during pregnancy but do want to recommend counselling and monitoring for appropriate gestational weight gain,” Khan said. “It is one of the few times in life that you are seeing the doctor frequently while you’re healthy.”
Pregnant individuals can safely limit their weight gain throughout pregnancy by eating healthy and exercising moderately or even vigorously, studies have shown.
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