Pregnancy is a life-changing time for women and can affect their health in a range of different ways. But, no matter what kind of experience a woman has, researchers are finding that pregnancy can also provide an extraordinary glimpse into a woman’s health—in particular, her heart health.
According to Janet M. Catov, PhD, MS, associate professor of obstetrics, gynecology, and reproductive sciences, School of Medicine, and of clinical and translational science at the University of Pittsburgh, many women experience pregnancies that progress typically and without significant health issues. However, she notes a few conditions that prenatal health care providers watch for and that can affect up to 20 percent of women who are pregnant. These conditions include preterm birth and preeclampsia.
Preeclampsia is a pregnancy complication with symptoms like high blood pressure, swollen hands and feet and protein in urine. If untreated, it can lead to brain seizures and a life-threatening condition called eclampsia. Research shows that it is a leading cause of preterm birth and maternal deaths (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3871181/). Although some treatments are available, the only known cure is for the mother to give birth.
Researchers like Dr. Catov recognize that preeclampsia and other pregnancy complications may be the body’s way of signaling a future health risk. She likens pregnancy to a stress test—a physical test to see whether the heart can adapt to the stress of exercise.
“We’ve begun to realize that these complications also identify women who are at higher risk for heart disease later in life,” says Dr. Catov, also associate professor of epidemiology at Pitt’s Graduate School of Public Health. “Healthy pregnancy requires every organ system to change. The body’s blood vessels and metabolism adapt significantly. The idea is that when a woman is pregnant and has a complication like preeclampsia, that may be a marker of underlying risk for heart disease. Preeclampsia goes away once the woman is no longer pregnant, but the physical reasons she developed high blood pressure in pregnancy don’t go away. In fact, several years after being pregnant, she may develop hypertension. Our research is trying to understand why.”
Through the Magee-Womens Research Institute and the University of Pittsburgh’s American Heart Association “Go Red for Women” Research Center, Dr. Catov runs the Windows study. The study examines how stress signals in pregnancy can be used to understand more about why some women with pregnancy complications go on to have excess risk for heart disease.
Because there are no certain predictors of preeclampsia, Dr. Catov says researchers need to understand more so they can help learn how to prevent it. But research shows that women who have had one complicated pregnancy have a higher chance of having complications in future pregnancies. Overall, researchers like Dr. Catov want to know more about heart disease risk in women specifically and to help women have better long-term health.
“We don’t know why pregnancy complications happen,” she says. “We really owe women answers. There’s sometimes a tendency to blame women—that somehow they’re doing something wrong, and that’s why they got sick during pregnancy. That’s not the case. We need to talk about and study these health issues so that women feel empowered with understanding so that they can take care of their health.”
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