Pregnancy complications linked to heart disease

India bears a heavy burden of heart disease. As of 2016, it is India’s most prominent killer, reaping a death toll of lives far in excess of any other condition. Pregnancy complications could be another addition to the already substantial list of risk factors.

Already in recent months COVID-19 has been added to the list of risk factors for developing heart disease. As millions across the country have already reportedly been infected, the news that even a mild infection with the viral condition can cause underlying heart issues on an ongoing basis is alarming. The additional risk factor could considerably increase heart disease rates across both India and the globe in the coming years.

Last year, it was reported that, over the preceding 25 years, India witnessed a fifty percent rise in heart disease cases according to doctors at the Meenakshi Mission Hospital and Research Centre. Data from 2016 indicates that heart disease was the cause of 28.1 percent of all deaths in the country. Pregnancy complications such as miscarriage, pre-eclampsia, gestational diabetes, early starting of periods and pre-term birth can increase the risk of heart disease and stroke in those affected by up to two-fold according to a systematic research review published in the British Medical Journal (BMJ).

“Women who have metabolic disorders during their reproductive age are three to four times more prone to diabetes and heart diseases later in life,” said Dr Niti Kautish, a senior gynaecologist at Fortis Hospital. “However, breastfeeding for up to two years helps because it reduces oestrogen exposure in feeding mothers and therefore, such women are likely to have no periods or delayed periods while they are feeding. Breastfeeding helps in reducing metabolic load and lends protection to the mother from many diseases.”

Pre-eclampsia was noted as having the greatest associated risk, with an associated four-fold increase in the rate of heart disease. A number of factors have been put forward as potential causes of the associated increase in heart disease risk, including family medical history; genetics; weight; high blood pressure and cholesterol levels; or the use of hormone-based contraceptive treatments.

The researchers noted some limitations of the review, such as missing data and the fact that reviews were largely based on observational evidence. This opens the possibility for outside factors to have played a role in the development of heart disease, rather than pregnancy complications being the sole, specific cause. The research thus presents a correlation — albeit one from a large sample size — rather than a proven causation, warranting further study. Given India’s concerning rate of heart disease, a greater understanding of any possible risk factors could be invaluable.