Coming up to 40, I’m starting to think more about my heart health. I saw a headline that having previously given birth preterm can increase risk of cardiovascular disease. But looking further, I couldn’t really understand the details — can you help me navigate the studies/data?
—As if having a 23-weeker wasn’t enough
In the rush of delivering a preemie and the weeks that follow, both parents and doctors are focused on the near future. Keeping mom and baby safe is the primary goal. Even when the urgency of the early days has subsided, many of us are distracted by related concerns, such as future pregnancies. The long-term implications of a complicated pregnancy can be forgotten.
It is true that many women who give birth preterm are at increased risk for developing cardiovascular risk in the future. This risk appears to be independent of traditional cardiovascular risk factors such as family history and elevated cholesterol. We don’t understand exactly how preterm delivery and cardiovascular disease are linked mechanistically. Researchers hypothesize that women who deliver preterm have a lot of inflammation in their blood vessels and that inflammation can also cause blockages to form in their arteries, leading to cardiovascular problems.
The cause of the preterm delivery — for example, spontaneous labor, preeclampsia, gestational diabetes — does impact your future risk. A review in Circulation lays out this risk in more detail. The authors looked at 83 studies that collectively enrolled more than 28 million women. They found that preeclampsia was associated with the largest increase in cardiovascular risk, with a 75% increase in risk compared to women with no history of preeclampsia.
Preterm birth is associated with a 63% increase in cardiovascular risk compared to women with no history of preterm birth. Other pregnancy complications associated with increased risk of cardiovascular disease include gestational hypertension, placental abruption, and gestational diabetes.
Preterm birth is not what doctors refer to as a modifiable risk factor. You can change your lifestyle — don’t smoke, get exercise, and eat well. You can’t change your genetics, and you can’t change that you had a preterm birth.
So how can you use this information to manage your health going forward? Make sure your doctors know this piece of your history, and consider establishing care with a cardiologist. That way, you can be sure you are doing everything you can manage your risk and treat issues early that crop up.
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Have these studies specified the increased risk for spontaneous preterm labor? Here it’s mentioned that the increased risk depends on the cause of preterm labor, but only the percentage for preeclampsia is listed, and I didn’t see the number for spontaneous labor in the linked article. I’m still a little confused on the causal relationship, i.e., whether the fact of giving birth preterm itself creates a problem later on or if it’s all rooted in whatever complication caused you to deliver preterm in the first place (especially since there are so many different reasons for preterm delivery, some of which are unexplainable). Thanks for any clarification!
Really excited to see commenting back!