Pre-eclampsia is a condition that can affect women in the second half of their pregnancy, after week 20, but can also develop after childbirth. Two signs define pre-eclampsia: new onset high blood pressure and protein in the urine.
Although more research is needed on the topic, experts believe that pre-eclampsia is caused by abnormal development of the placenta.
As Dr William Cooke notes in his article on pre-eclampsia, the condition can cause severe headaches, issues with vision, pain beneath the ribs, vomiting, and peripheral oedema (swelling in the hands and feet). Left untreated, it can also lead to several serious complications, including HELLP syndrome, eclampsia (seizures or fits), preterm birth, foetal growth restriction, and stillbirth. It’s therefore crucial that women with pre-eclampsia are closely monitored throughout the remaining weeks of their pregnancy and after delivery.
Pre-eclampsia usually improves with the delivery of the placenta. However, women who have had the condition are at greater risk of encountering other health issues, such as hypertension and heart disease, after childbirth.
While the link between pre-eclampsia and heart problems has long been established, scientists have been unsure of the severity of the risk and whether it changes over time following childbirth.
Now, a new Danish study, the first of its kind, has provided some insight into this uncertainty.
The study, published in the European Journal of Preventative Cardiology, included 1,577,666 pregnant women in Denmark. Researchers from the University of Copenhagen looked at women who had at least one pregnancy between 1978 and 2017, following them for a maximum of 39 years post-childbirth.
They further divided the women into sub-groups – those who developed pre-eclampsia and those who did not – and looked at the incidences of heart attacks and ischaemic strokes among the two groups. The notable differences in incidences became clear just seven years after delivery.
Upon analysis, the researchers found that, within two decades of delivery, two per cent of the pre-eclampsia group suffered a heart attack or stroke, compared with just over one per cent of women without pre-eclampsia. Furthermore, women with pre-eclampsia were four times more likely to have a heart attack and three times more likely to have a stroke ten years after delivery. The results also indicated that the risk of heart attack or stroke remained throughout later life; it was twice as high for the pre-eclampsia group more than 20 years after delivery, when the women were older than 50.
The study’s lead author, Dr Sara Hallum of the University of Copenhagen, believes that more should be done sooner to help women who have had pre-eclampsia lower their risk of heart problems.
“The high risk of cardiovascular disease after pre-eclampsia manifests at young ages and early after delivery,” she said. “This indicates that interventions to prevent heart attacks and strokes in affected women cannot wait until middle age when they become eligible for conventional cardiovascular screening programmes.”
She recommends that women with pre-eclampsia should have regular check-ups where their blood pressure is monitored and that they be screened regularly for cardiovascular disease. Such preventative measures should start within a decade of childbirth.
“Our study suggests that the women most likely to benefit from screening are those who had pre-eclampsia after age 35 and those who had it more than once,” said Dr Sara Hallum. “Prevention should start within a decade of delivery, for example by treating high blood pressure and informing women about risk factors for heart disease such as smoking and inactivity.”
There is much that is still unknown about pre-eclampsia, but studies such as this one will help medical experts make the best choices regarding pregnant women’s care, leading to better outcomes for mothers and their babies.
If you’re worried about pre-eclampsia, speak to your midwife or doctor. They will carry out the necessary tests and, if you are diagnosed with the condition, prescribe blood pressure medication and provide you with further guidance. While there is no guaranteed way to prevent pre-eclampsia from developing, it is a good idea to maintain a healthy diet and light exercise routine, as these will help lower blood pressure and reduce the risk of cardiovascular disease.