Postpartum risk: Pregnant women found to have increased chance of heart failure in the weeks following delivery

While it is a natural and beautiful part of life, childbirth isn’t without dangers, especially for mothers. According to a recent study, heart failure can occur during pregnancy and certain women are at higher risk compared to others.

In the case of Golda Black, she experienced a “persistent cough while lying down” and “fatigue, dizziness, and chest pains” after she gave birth to her third child. When she looked up her symptoms online, her results often showed up as heart failure. When her third son, Cooper, was 10 weeks old, a test revealed that Black’s heart was only “working at 10 to 15 percent of its capacity.” She was then diagnosed with peripartum cardiomyopathy and chronic heart failure.

In the U.S., heart failure is one of the leading causes of maternal morbidity and death. The rate of pregnancy-related deaths more than doubled from 1987 to 2011. However, not much is known about heart failure “before, during, and after delivery.”(Related: Maternal mortality rates rise in U.S. despite so-called ‘improvements’ in healthcare.)

In a recent study, researchers looked into “when heart failure occurs during pregnancy and those at highest risk.” The scientists caution that “multidisciplinary medical teams” must be more careful and that patients need to be more aware of these dangers. Targeted public health measures can help improve outcomes and reduce instances like Black’s.

The findings determined that less than two percent of “all pregnancy-related hospitalizations were due [to] heart failure.” However, at least 60 percent of the pregnancy-related heart failure hospitalizations took place during the six-week period after childbirth.

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Dr. Mulubrhan F. Mogos, the study’s lead author, explains that the results indicate “significant clinical implications,” which can be assuaged with early intervention. Monitoring the postpartum period is critical since women are discharged a few days after they give birth. These mothers aren’t evaluated by health care providers until six weeks later, which means symptoms might be left “unrecognized and untreated.”

For the study, researchers examined over 50 million pregnancy-related hospitalizations in the U.S. starting from 2001 to 2011. From 2001 to 2006, a 7.1 percent increase was reported annually in heart failure diagnoses for postpartum hospitalizations. A steady rate was noted through 2011.

Heart failure rates during the antepartum period (prior to delivery) went up by almost 4.9 percent yearly by 2001 to 2011. Researchers posit that this could be due to “high blood pressure, diabetes, and other risk factors that women already had before becoming pregnant.” They commented that testing could be improved to detect heart failure. There were also some differences in the women who were diagnosed with heart failure. These patients were often “older, black, live in the South and in a lower household income area, and use tobacco, drugs or alcohol.”

Dr. JoAnn Lindenfeld, who didn’t take part in the study, leads clinical research as director of the Advanced Heart Failure/Cardiac Transplantation programs at Vanderbilt University in Nashville. Dr. Lindenfeld shares that the study findings can be used to improve the screening for high-risk patients before they are discharged from the hospital. She advises that the earlier peripartum cardiomyopathy is diagnosed, the easier it will be to “prevent re-hospitalization and improve outcomes.” The study emphasizes the need to educate patients about the risks of heart failure and how to recognize the symptoms of heart failure.

Dr. Mogos adds that awareness is a must, especially for patients who could have other conditions during pregnancy like preeclampsia (symptoms include the onset of high blood pressure and a high amount of protein in the urine) or gestational diabetes. He concluded, “When care transitions from the OB/GYN to the primary care physician, there isn’t always good communication, especially if symptoms have gone away.”

Fast facts on peripartum cardiomyopathy

• Peripartum cardiomyopathy (PPCM), or postpartum cardiomyopathy, is an uncommon form of heart failure that occurs during the last month of pregnancy.
• PPCM can also happen up to five months after giving birth.
• “Cardiomyopathy” literally means “heart muscle disease.”
• PPCM is a dilated form of the disease where the heart chambers enlarge and the muscle weakens. This leads to a decrease in the percentage of blood ejected from the left ventricle of the heart with each contraction. This can cause decreased blood flow and the heart might no longer be able to meet the demands of the body’s organs for oxygen, and this can affect “the lungs, liver, and other body systems.”

You can read more articles about infant health and pregnancy news at WomensHealth.news.

Sources include:

News.Heart.org

Heart.org