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Pregnancy can affect your heart health both during pregnancy and long after you’ve given birth.

Cardiovascular disease (CVD) is, in fact, the leading cause of pregnancy-related death, according to the American Heart Association. CVD is an umbrella term for heart and blood vessel problems. It includes heart disease — problems with the structure and function of your heart.

Black, Hispanic, and Asian women face even higher risks of pregnancy complications and CVD risk factors compared to white women. Researchers need to conduct more studies to understand exactly why.

How Does Pregnancy Affect Heart Health?

When you’re pregnant, your heart works harder to pump blood to you and your baby. If you had heart health issues before pregnancy, this extra stress can worsen these problems.

The added stress on your heart can also cause new heart-related health problems during pregnancy. These include diabetes, high blood pressure, and preeclampsia. These issues can happen during pregnancy, in labor and delivery, and up to a year after childbirth.

Though stroke during pregnancy is rare, it’s also on the rise. That’s according to the Centers for Disease Control and Prevention (CDC).

What are risk factors for heart complications during pregnancy?

Heart complications during pregnancy can have life-threatening implications and affect postpartum heart health considerations. Anyone can develop these pregnancy-related heart problems. You may have a greater risk of developing these problems, however, if you:

• Are Black, American Indian, or Alaska Native.
• Are 40 or older.
• Are overweight or obese.
• Drink alcohol.
• Get little physical activity.
• Have existing heart problems, including types of heart disease such as congenital heart disease or heart valve disease.
• Have an underlying health condition. This includes anemia, diabetes, blood clotting disorders, high blood pressure, sleep apnea, or polycystic ovary syndrome (PCOS).
• Smoke.
• Use opioids or other illegal drugs.

Which Pregnancy Complications Can Cause Heart Disease Later in Life?

Heart complications after pregnancy include CVD and stroke. According to the American Heart Association (AHA), six pregnancy complications can increase a woman’s risk of CVD later in life. They include:

1. Gestational diabetes

This is when you develop type 2 diabetes during pregnancy. It increases a woman’s CVD risk by 68%. It also increases the risk of type 2 diabetes after pregnancy tenfold.

2. Gestational hypertension

According to the National Heart, Lung, and Blood Institute, high blood pressure occurs in one out of every 12 to 17 pregnancies in the U.S.

High blood pressure during pregnancy increases a woman’s risk of CVD later in life by 67%. It also increases the chances of a stroke by 83%.

Gestational hypertension is when blood pressure during pregnancy is at or above 140/90 millimeters of mercury (mm Hg) after 20 weeks of pregnancy in someone with previously normal readings.

Researchers link preeclampsia — gestational hypertension and signs of damage to the liver, kidneys, or another vital organ — to a 2.7 times higher risk of CVD later in life.

3. Placental abruption

This is a serious condition that happens when the placenta separates from the wall of the uterus before the baby’s birth. It affects 1% of pregnancies, according to March of Dimes. Placental abruption increases the risk of CVD by 82%.

4. Pregnancy loss

Stillbirth — when a baby dies before delivery — doubles the risk of CVD.

5. Preterm delivery

Preterm delivery is when you give birth before 37 weeks gestation. It doubles a woman’s risk of developing CVD.

6. Small-for-gestational age delivery

Giving birth to a small-for-gestational-age baby also increases a woman’s CVD risk.

These may all add to the increased risk of CVD women face during menopause.

The drop in estrogen hormone during menopause is one of many factors that can contribute to menopause hypertension. Researchers have correlated hot flashes and night sweats, common menopause symptoms, to an increased risk of high blood pressure and other CVD risk factors.

How Can I Manage My Heart Health During and After Pregnancy?

Protecting your heart health during and after pregnancy starts with preventing pregnancy complications before they start. It also means monitoring your heart health more closely if you have any of the above complications during pregnancy and childbirth.

If you’re pregnant or planning on becoming pregnant, it’s important to understand your risks for CVD. The risk factors listed above may help. Also, follow these tips:

Know the symptoms of heart disease in women

Symptoms of CVD depend on your heart condition. Heart disease symptoms in women related to heart attack — a common consequence of CVD — include:

• Anxiety.
• Breaking out in a cold sweat.
• Chest pain or discomfort — the most common symptom.
• Discomfort or pain in the arms (one or both), back, jaw, neck, and shoulders.
• Feeling faint or lightheaded.
• Nausea or upset stomach.
• Shortness of breath (with or without chest discomfort).
• Unexplained or unusual tiredness or weakness.
• Vomiting.

Get heart health screenings

Signs of heart disease are things your doctor can see or measure. To check for early signs of heart problems in women and men, the AHA recommends the following heart health screenings:

• Blood pressure readings during every routine checkup.
• Cholesterol blood tests performed every four to six years for adults at normal risk of heart disease.
• Discussing your diet, smoking, and lifestyle habits at every routine checkup.
• Waist circumference measurement as needed if your BMI is equal to or greater than 25 kilograms per square meter (kg/m²).
• Weight and body mass index (BMI) measurements during every routine checkup.

These screenings can help your doctor understand your risk of heart disease. They can recommend lifestyle changes and medicines that may help reduce your risk of heart disease and pregnancy complications.

Follow heart-healthy habits

These are some of the lifestyle changes that may help:

• Eating a healthy diet three years before pregnancy lowers the risks of pregnancy complications. That’s according to the AHA scientific statement on pregnancy and heart health.
• Getting regular physical activity before, during, and after pregnancy.
• Maintaining a healthy weight.
• Managing stress.
• Practicing healthy sleep habits and getting enough sleep.
• Quitting smoking if you smoke.

Get help for pregnancy warning signs

Along with heart attack signs, call 911 or get immediate medical help if you have any of these warning signs during pregnancy or postpartum:

• Baby’s movements have slowed or stopped.
• Chest pain or rapid heartbeat.
• Dizziness or fainting.
• Extreme swelling of your face and hands.
• Extreme tiredness.
• Fever of 100.4 F or higher.
• Headache that won’t go away or worsens over time.
• Severe belly pain that doesn’t go away.
• Severe nausea or vomiting.
• Severe pain, redness, or swelling in your arm or leg.
• Thoughts of harming yourself or your baby.
• Trouble breathing.
• Vaginal bleeding or fluid leaking during pregnancy; heavy vaginal bleeding or discharge after pregnancy.
• Vision changes.

If you have pregnancy complications, the AHA recommends getting closely monitored for CVD throughout your lifetime. This includes longer postpartum care so your doctor can screen you for CVD risk factors and counsel you on CVD prevention strategies.