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Postmenopausal? What Your Doctor Needs to Know About Your Past Pregnancies

Published
January 19, 2012
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HealthyWoman from Bottom Line
Source
George Saade, MD
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Unless you have been with the same primary care physician since before all of your babies were born, your current doctor may not know about any pregnancy complications you experienced. Why this worries me: Problems during pregnancy, even if they occurred long ago, provide important clues about your current and future risk for potentially serious disorders—clues your doctor must be aware of in order to offer you optimal care.

I spoke about this with George Saade, MD, a professor of obstetrics and gynecology and chief of maternal-fetal medicine at the University of Texas Medical Branch in Galveston. Dr. Saade told me, “Pregnancy complications are equally as important risk factors as whether you smoke or have a family history of chronic health conditions like heart disease or diabetes—so it strikes me as odd that many doctors neglect to ask patients about their pregnancy history.”

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Pregnancy complications of concern include…

  • Gestational hypertension (high blood pressure that develops during pregnancy) or preeclampsia (high blood pressure and excess protein in the urine after the twentieth week of pregnancy).
  • Gestational diabetes (diabetes that develops during pregnancy).
  • Delivering a baby with a low birth weight (below five pounds, eight ounces).
  • Delivering a premature baby (before 37 weeks’ gestation).
  • Stillbirth.

A history of such complications may increase your risk for…

Cardiovascular problems. A recent study in Obstetrics & Gynecology looked at 15,065 Norwegian women who gave birth to their first child between 1967 and 1995, examining various aspects of their health an average of 16.5 years after their pregnancies. Compared with participants who had normal blood pressure during pregnancy, those who had had hypertension while pregnant had higher blood pressure and unfavorable levels of total cholesterol, LDL “bad” cholesterol and triglycerides (a type of blood fat). These factors increase a person’s risk for heart attack and stroke.

That’s not all. Other studies found that women with a history of preeclampsia had approximately double the risk for coronary heart disease, stroke and blood clots… that women who had delivered a preterm infant had nearly triple the risk for cardiovascular disease… and that women who delivered a low-birth-weight baby had seven to 11 times the usual risk of dying from cardiovascular causes.

Diabetes. Even if their blood glucose levels return to normal in the postpartum period, women who had gestational diabetes are at significantly increased risk for developing type 2 diabetes later in life. Women with a history of preterm delivery also are more likely to develop diabetes later on. And according to a Danish study, women who had had blood pressure problems during pregnancy had a more than threefold increased risk for subsequent diabetes.

Kidney disease. Studies link preeclampsia, preterm delivery and/or having a low birth-weight baby with later development of kidney problems. Also, Israeli researchers found that women who had delivered stillborn babies had a 4.7-fold increased risk of dying from kidney-related causes.

Though researchers don’t yet fully understand why pregnancy complications increase certain health risks later in life, Dr. Saade said that it is likely that pregnancy unmasks a predisposition to these chronic diseases or conditions. “If you are already predisposed to hypertension, for example, it may first show up when you’re pregnant because of the additional demands that pregnancy puts on your body,” he explained.

To protect yourself…

  • Describe any pregnancy complications to your primary care doctor in as much detail as you can recall… if possible, get a copy of your medical records from your obstetrician. If you experienced problems during more than one pregnancy, emphasize that fact—studies show that repeated pregnancy complications put you at even greater risk.
  • With your doctor, discuss getting extra screening tests for cardiovascular, metabolic and kidney disorders, as appropriate.
  • Prevention is the best medicine—so it is especially important that you commit to a healthy lifestyle. Eating nutritious foods, exercising regularly, controlling your weight and not smoking can go a long way toward offsetting the future health risks that accompanied the pregnancy complications of your past.