Heart Health Prior to Pregnancy Is Important, Says Report

Getting pregnant can be one of the most exciting steps in your life. To ensure a healthy pregnancy for both yourself and the baby, it is important to take good care of your health, even prior to getting pregnant.

New research by the American Heart Association published in Circulation says women’s heart health before pregnancy can largely impact the risk associated with pregnancy, and long-term cardiovascular health for both the mother and the baby. Unsurprisingly, the mother’s health impacts the baby once pregnancy begins. However, improving heart health before pregnancy can be crucial to ending the generational sequence of poor cardiovascular health, which is common in the United States.

For women impacted by poor social conditions and institutional racism, taking care of their health before pregnancy is especially important. "If you optimize the pre-pregnancy health of the mother, that optimizes her health during pregnancy, which affects the health of the child later in life," shared vice chair of the statement writing committee Holly Gooding, M.D. and associate professor at Emory University School of Medicine. Cardiovascular disease, an umbrella term for any disease related to the heart or blood vessels, makes up more than one in four pregnancy-linked deaths in the U.S.

To add to the problem, more pregnancy-linked risks have occurred, per the new report. Around one in five pregnancies is affected by various health complications, including high blood pressure, premature births, low birth weights, and gestational diabetes. Risks associated with high blood pressure have doubled over the past decade and these types of pregnancies have increased risks for cardiovascular disease for both mother and babies afterward.

The study also suggested Black women are excessively impacted, as they confront pregnancy-linked risks approximately three times more than white women. "This statement looks upstream at what the potential contributors to that rising burden may be," said the writing committee chair and an assistant professor of medicine at Northwestern University Feinberg School of Medicine in Chicago Sadiya Khan, M.D.

Pregnancy-affiliated risks and the mother's and baby's cardiovascular health are associated with women's heart risk factors both before and after pregnancy. This convenes for additional research to enhance women's health during pregnancy and into childhood. Additionally, it highlights the necessity of policy adjustments to eliminate structural racism and other negative social factors that impede improved maternal health. "Identifying ways to intervene and equitably promote health is critical," continued Khan.

According to Gooding, the writing committee decided to widen the definition of pre-pregnancy to include all childbearing years. That age range, which varies individually, is approximately between 15 and 44.

"We avoided defining it on purpose because that's something further study needs to address," said Khan. "When is the opportune time prior to pregnancy to intervene? On a population and public health level, we want to take a life-course perspective on this, begin focusing on prioritizing cardiovascular health at that time when a person comes of reproductive age."

How can we improve our heart health?

To make sure you have good heart health, despite your age, Khan said it is crucial to follow health measurements set in AHA’s Life Essential 8.

The key points include:

• No smoking
• Enough Sleep
• Physical activity
• Healthy weight
• Healthy diet
• Maintaining healthy blood pressure, blood glucose, and cholesterol levels

Although following these steps is essential for everyone, Khan said it is also crucial that women have adequate healthcare to receive help when they need it. Women need accessible healthcare and primary care physicians throughout their life, even before they become pregnant, to ensure they can endure a healthy pregnancy later on in life. It is also vital that sufficient doctors are available to check cardiovascular risk factors.

She concluded: "It's a natural conclusion to say we should all prioritize cardiovascular health, but it's important we not put the onus just on the individual."

According to the report, the emphasis of future research ought to focus on locating techniques supported by evidence to lessen the health troubles of mothers and how such systems might alleviate the burden of cardiovascular disease in general.

A free e-learning program on cultural competency for maternal healthcare professionals was launched in 2021 by the federal Office of Minority Health. In addition, the White House released a plan for disclosing maternal health the previous year that included efforts to enhance financial and social support for pregnant women throughout their pregnancies. Programs to lower blood pressure for childbearing-age Native Americans and veterans were also included.