Pregnancy & Heart Disease
Most of the poor outcomes are seen in women of color. Over 700 women die in the United States of America each year as a result of pregnancy related complications.
African American, American Indian and Alaska Native women are 3 times more likely to die from a pregnancy related cause than Caucasian women. CDC May 2019 report.
Over 33% of pregnancy related deaths were related to cardiovascular conditions. MMWR 2019
Common Conditions which complicate pregnancies and increase the risk to mothers:
-Hypertensive Disorders During Pregnancy (High Blood Pressure during Pregnancy)
High blood pressure during pregnancy occurs when the blood pressure of a pregnant woman is over 140/90.
- Pre-eclampsia or Eclampsia is High Blood Pressure beginning during pregnancy and can be associated with other severe complications and abnormalities such as: abnormal blood clotting, seizures, protein in the urine, abnormal kidney function or liver function.
- Chronic Hypertension (High Blood Pressure that was present prior to pregnancy and not directly related to Pregnancy). Sometimes this form of high blood pressure is also seen in association with pre-eclampsia and its complications.
- Gestational Hypertension is new hypertension occurring after 20 weeks of pregnancy and NOT associated with any other abnormalities.
-Peripartum Cardiomyopathy is weakness of the heart muscle leading to a condition called “cardiomyopathy”. This condition can occur during pregnancy. Women who develop this condition can become quite ill and develop the symptoms of heart failure with shortness of breath, swelling of the lower legs, leaky heart valves and abnormal heart rhythms. In severe cases, women need a heart transplant. The heart muscle can improve after delivery in most women, however, for some women, the heart function remains abnormal after delivery.
Risk factors for the development of a Peripartum Cardiomyopathy include:
- Advanced maternal age (older mothers, over 30 years)
- History of Pre-eclampsia or Prior Hypertension
- African American Race
Serena Williams holds 23 Grand Slam Single titles in women’s tennis and is the former # 1 women’s single tennis player in the world. She is an icon in the world of tennis and in 2017 she delivered her first child at age 36.
She was in excellent health but had a history in the past of blood clots and Pulmonary Embolism.
Here’s her story, in her own words- insert video.
Learn more about Venous Thromboembolism (deep vein thrombosis or clots) during pregnancy:
- Pregnant women are susceptible to developing blood clots most commonly in the left leg and are more common after caesarean sections (c-sections).
- Blood clots can occur anytime during pregnancy and up to 6 weeks after pregnancy.
- Pulmonary embolism is a condition which occurs when a blood clot from the lower legs travels to the lungs. It can cause shortness of breath, chest pain and in some cases death.
Who is at risk?
Several pre-existing conditions place women at risk. Some of them are listed below: (this is a partial list)
- Pre-existing heart disease
- Coagulation disorders
- Family history of blood clots.
Learn about other conditions which can complicate pregnancy: WomenHeart infographics
COVID-19 and Pregnancy
The current information on pregnancy outcomes and coronavirus infections are limited. Available studies have shown that asymptomatic corona virus infections are common among pregnant women. While most women will have an uneventful pregnancy if infected with coronavirus, there have been reports of severe symptomatic coronavirus infections among pregnant women leading to poor outcomes in as high as 9% of pregnant women.
Hospitalized patients with COVID-19 infection had higher rates of preterm birth, preeclampsia, cesarean section and fetal deaths.
While studies regarding the impact of COVID-19 and pregnancy are ongoing, several things have been shown
- Moms can safely breast feed their infants even if they test positive for COVID-19- IF they take appropriate precautions (handwashing and face masks on the mom)
Pregnancy and the COVID-19 Vaccine. Should I get the new Vaccine?
The studies of the corona virus vaccines in pregnancy are currently ongoing and information is not yet available. However, the consensus is that if the benefit outweighs the risks, vaccines should be given during pregnancy. The types of vaccines which are used during pregnancy are NOT attenuated live vaccines and are generally deemed safe.
The first 2 COVID-19 vaccines are NOT attenuated live virus vaccines and thus those who meet the criteria for receiving the vaccine may choose to receive the vaccine during their pregnancy.
There is no evidence that the current 2 vaccines are associated with causing infertility.