Around Australia, 22 women die every day from heart disease. In fact, heart disease kills more women than cancer, nearly three times as many women as breast cancer. While the basic building blocks of our hearts are the same as men, there are some strong biologic differences between a man’s heart and a woman’s heart. These differences contribute to why women do much worse than men when it comes to their hearts.
Pregnancy is seen as the ultimate ‘stress test’ for a woman’s heart. This year, as part of June’s ‘Making the Invisible Visible’ campaign run by the Heart Foundation, we’re raising awareness around the changes to a woman’s heart during and after pregnancy.
Why is pregnancy a ‘stress test’?
Particularly in a developed country like Australia, most pregnancies are uncomplicated and mum and baby remain completely well. That being said, the process of growing a whole human sparks a number of changes in a woman’s body. Some of these changes are normal and healthy, driven by hormones to help the mother look after her growing baby. However, in some women, pregnancy can unmask or create problems such as diabetes, hypertension (high blood pressure) or pre-eclampsia.
What is gestational diabetes?
Gestational diabetes refers to diabetes that develops during gestation or pregnancy. It’s when a woman who didn’t have diabetes before her pregnancy develops high blood sugar during her pregnancy and is often asymptomatic. For that reason, pregnant women are checked for diabetes by undergoing a glucose tolerance test between 24 and 28 weeks.
In Australia, between 12-14% of women develop diabetes during pregnancy with women who are older, have a family or personal history of diabetes, have polycystic ovarian syndrome amongst other risks are more likely to get it. After delivery, the diabetes does tend to resolve but the issues don’t stop there. Over the longer term, those with gestational diabetes are at higher risk for developing more permanent forms of diabetes (type 2 diabetes) and cardiovascular disease such as a heart attack of stroke.
What is hypertension and pre-eclampsia?
During pregnancy, hypertension or high blood pressure can occur. It’s not concrete as to why this happens, there may be causes related to the changes of pregnancy itself or due to mum’s baseline risk of high blood pressure. Around 30,000 women a year develop high blood pressure in pregnancy and 10,000 of these women go on to get pre-eclampsia.
Pre-eclampsia is an illness in pregnancy when we see high blood pressure plus protein in the urine. It can lead to much more dangerous problems such as liver disease, low platelets, kidney dysfunction, fluid in the lungs and visual changes. It can in very severe cases lead to seizures which is known as eclampsia and is a medical emergency for mum and baby. Like diabetes, these things do tend to get better when the baby is born.
Also like diabetes, the risk doesn’t vanish though. For women who have had hypertension or pre-eclampsia, they are at least twice as likely to have high blood pressure, diabetes, stroke or heart attacks down the track.
Can I prevent these illnesses?
Although we haven’t yet gotten to the bottom of what causes diabetes and pre-eclampsia, or what preventative measures work, being active and eating well is a good way to have a healthy pregnancy. Quitting smoking is one way that we can reduce your risk of pre-eclampsia.
What about after the birth?
Although these illnesses go away after birth, the after effects linger for some years. To keep ahead of them, ensure you lead a healthy lifestyle with plenty of exercise, healthful foods and don’t smoke.
What we would recommend for women who have had diabetes or pre-eclampsia in pregnancy is to stay extra vigilant with their lifestyle. These women should also have an annual blood pressure check and at least a five-yearly check of glucose and lipids. In future pregnancies, it’s vital to be on the look-out for diabetes and high blood pressure as they can occur again. And of course, ensure your doctor knows about your history and keeps an extra close eye on your heart.
This article constitutes general advice only and is not a substitute for individual medical advice. See your doctor to discuss your situation further or call 000 in a medical emergency.