Placenta Problems Predict Early Heart Trouble

Obesity may help trigger pregnancy complications and later cardiovascular woes, study finds

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By Steven Reinberg
HealthDay Reporter

THURSDAY, Nov. 17, 2005 (HealthDay News) -- Pregnant women with abnormal placentas appear to be at a twofold risk of developing early cardiovascular disease compared to women without these problems, Canadian researchers report.

Maternal placental syndromes include preeclampsia (high blood pressure during pregnancy) and conditions where the placental blood vessels become blocked. These include placental abruption and placental infarction, where the placenta becomes detached from the wall of the uterus.

Risk factors for placental syndromes include obesity, insulin resistance, high blood pressure and high cholesterol. These same conditions are also independent risk factors for cardiovascular disease.

"We looked at more than 1 million women who delivered," said study author Dr. Joel G. Ray, an assistant professor of obstetrics and gynecology at St. Michael's Hospital of the University of Toronto. "We examined whether they experienced a problem with their placenta or not."

In the CHAMPS (Cardiovascular Health After Maternal Placental Syndromes) study, Ray and his colleagues found that of the 1.03 million women in the study, 75,380 were diagnosed with maternal placental syndrome. The average age of the women in the study was 28 years.

Reporting in the Nov. 19 issue of The Lancet, the researchers compared the health outcomes of women who had placenta problems with women who didn't. "We looked at their future risk of having heart disease or stroke or blockage of one of the arteries to the legs," Ray said.

"We found that women who had placental syndromes had double the risk of developing premature cardiovascular disease, compared with women who didn't have one of those maternal placental syndromes," Ray said.

He believes that obesity before pregnancy is largely responsible for developing these syndromes. Many of the women who develop maternal placental syndromes have an abnormal metabolic state long before pregnancy, during pregnancy and after delivery, he said.

"We think that a lot of the risk for maternal placental syndromes is coming from the presence of obesity before pregnancy," Ray said. Conditions closely related to obesity, such as diabetes and high blood pressure, "create an environment that is unhealthy for the placenta and remains an unhealthy environment after the women delivers," he said.

Ray believes women can change their lifestyle and reduce their chances of maternal placental syndromes and premature heart disease.

"It isn't that hopeless," he said. "The metabolic state, to a degree, is determined by their body weight and what they eat. This study shows that there is a window for women to modify their health while they are young."

Another expert sees the study as important research into the special heart disease risks faced by women.

"We are now starting to think about things that are unique to women that can also give us clues to their risk of cardiovascular disease in the future," said Dr. Nieca Goldberg, chief of women's cardiac care at Lenox Hill Hospital, New York City and author of Women Are Not Small Men. "Before, we were looking at the traditional risk factors that predict cardiovascular disease in men."

Goldberg believes that any woman who has had a maternal placental syndrome should be watched carefully for the onset of cardiovascular disease. "Women who have had preeclampsia or other pregnancy problems shouldn't get lost to the health-care system," she said.

"We really need to make sure that we instill the advice of healthy lifestyle behavior in these young women," Goldberg said.

More information

For more on women and heart disease, head to the National Women's Health Information Center.

SOURCES: Joel G. Ray, M.D., assistant professor, obstetrics and gynecology, St. Michael's Hospital, University of Toronto; Nieca Goldberg, M.D., chief, women's cardiac care, Lenox Hill Hospital, New York City; Nov. 19, 2005, The Lancet

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