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Many doctors and patients have long considered two common pregnancy complications as temporary medical problems that essentially go away once the baby is born.
Now there's growing recognition that expectant women who have preeclampsia or gestational diabetes are at much greater risk of developing illness well beyond the baby's birth, including cardiovascular disease and diabetes, compared to women with uncomplicated pregnancies. What's more, the complications have been linked to health problems in the children as late as early adulthood, researchers say.
The medical findings led the American Heart Association last month to issue updated guidelines that list a problem pregnancy as a risk factor for a woman to develop heart problems, along with such well-established dangers as smoking and high cholesterol. The two chief culprits identified in the guidelines, preeclampsia and gestational diabetes, are potentially serious complications that have long been known for their immediate danger to both the mother and the baby.
Preeclampsia, a rapid rise in blood pressure, more than doubles a mother's chance of developing cardiovascular disease, stroke or other conditions five to 15 years after the pregnancy, according to a study of nearly 3.5 million women published in 2007 in the British Medical Journal. Meanwhile, gestational diabetes, a type of diabetes that occurs only during pregnancy, increases both the mother's and baby's risk of developing the full-blown condition later in life.
Both complications can have other long-term consequences for the baby. A study of more than 280,000 Swedish men published in January in the AHA journal Circulation found that those born to mothers with gestational diabetes were more likely to be overweight at age 18 than those whose mothers were free of the complication. A Finnish study published in 2009 in the journal Stroke found a higher risk of stroke in adults born after pregnancies complicated by preeclampsia or high blood pressure.
'How a woman does in her pregnancy gives you a glimpse of what the future will be 10 years down the line,' says Jennifer Mieres, a cardiologist at North Shore-LIJ Health System, Long Island, N.Y., and a national spokeswoman for the AHA.
Most medical experts believe that a difficult pregnancy, by putting unusual strains on the body, provides a warning sign for heart risks that are already there. However, the connection between the pregnancy complications and later health risks isn't well understood.
'Pregnancy is like a stress test for the heart,' says Heidi Connolly, a cardiologist at Mayo Clinic, Rochester, Minn., with a special interest in pregnancy and heart disease. 2011-03-24
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