Pregnancy as a Stress TestAug 10, 2022
Pregnancy is a stress test. What does that mean!? Think of pregnancy as an early warning system. Some conditions that come up during pregnancy might mean you are at higher risk down the road of being affected by chronic disease. But this doesn’t mean there isn’t anything you can do about it. Join Drs. Sarah & Alicia on today’s podcast as they outline the two most common conditions in pregnancy that can be an indicator of your future health, and what you can do to prevent or reduce the risk!
There are so many changes that occur in pregnancy, some that we see, some that we feel and some that occur within our bodies that we may not be aware of. Today we’re focusing on two conditions that can occur in pregnancy and that can often be indicators of health issues down the road.
Gestational diabetes is a condition characterized by an elevated level of glucose in the blood during pregnancy, typically resolving after the birth. It occurs when the pancreas cannot keep up with the insulin needs of the cells to properly manage sugar loads. If it occurs in pregnancy, it can be a signal that as the years progress, the pancreas may not be able to keep up with the insulin requirements long term, leading to what is known as insulin resistance. This means that it takes more and more insulin to do the work as it used to, wearing down the pancreas, making it no longer able to produce enough insulin to get the sugar in your blood into your cells and your blood sugar levels start to creep up.
Hypertensive disorders of pregnancy
There are several types of hypertensive disorders in pregnancy, including:
- High blood pressure in pregnancy: including pre-eclampsia and eclampsia
- Intrauterine growth restriction: this is defined as below the 10 percentile for weight for all babies at the same gestational age
- Placental abruption: when the placenta separates from your uterus before your baby is delivered
- Idiopathic Preterm Delivery: when the baby is born before 37 weeks of gestation or three weeks before the due date, without predetermined cause such as multiple pregnancies or a different shape of the uterus
- Gestational diabetes: people with Type 2 Diabetes have a higher rate of cardiovascular disease than those without
To refresh your memory or knowledge of these conditions, check out our previous podcasts on Hypertensive Disorders of Pregnancy, Gestational Diabetes in Pregnancy, and GDM Tips and Tricks from a Dietician!
What are the risks?
The risk of developing Type 2 diabetes if you had gestational diabetes in pregnancy is about seven times higher than for those who didn’t experience gestational diabetes. It is estimated that between 20%-50% of people who were diagnosed with gestational diabetes in pregnancy will go on to develop type 2 diabetes at some point in their lifetime.
It is estimated that about 20% of pregnancies are affected with at least one type of hypertensive disorder, which is a big chunk of our population! The data is not perfect, but compared to a pregnant person not affected by one of the above outlined complications, here is a breakdown of the likelihood of developing a hypertensive disorder after pregnancy if you experienced one during:
- 3-4x the risk of developing long term high blood pressure
- 4.2x the risk of developing heart failure
- 2x the risk of having a stroke
- 5-12x the risk of having kidney failure
- 2x the risk of atrial arrhythmia - such as atrial fibrillation
- 2x the risk of having coronary artery disease which can lead to a heart attack
What can you do?
While these stats can seem scary, it’s helpful to consider them as opportunities to look at how you can help your older self by making some very important changes right now! While our health profile is complex and there are many affecting factors - both genetic and societal - here are a few suggestions of how you can decrease your long term risk moving forward!
- Exercise: aim for 150 minutes of cardiovascular and strength training a week. This is about 20-30 minutes a day! The benefits of exercise can also have a huge impact on your mental health, as we know exercise helps to decrease postpartum depression symptoms.
- Nutrition: weight loss can be a factor, but this point is more about what you are eating and the science of decreasing your long term cardiovascular risk with the food you consume. If you need clear cut recommendations, consider DASH (Dietary Approaches to Stopping Hypertension) or the Mediterranean diet. Both generally emphasize whole grains, fruits and vegetables, legumes, nuts, fish, poultry and moderate dairy and heart healthy oils (such as avocado or olive oil).
- Smoking: smoking cigarettes, marijuana, and vaping all increase our risk of cardiovascular disease, among other health challenges. Decreasing or stopping smoking can significantly decrease your risk of long term health complications. Check out QuitNow.ca for some great ideas and support around decreasing or quitting smoking.
- Breastfeeding: not everyone is able to or wants to breastfeed and that is okay, but there is good evidence around breastfeeding and decreasing diabetes, obesity, and long term cardiovascular health. Data that tells us if you breastfeed for longer than 12 months in your life, you will decrease your risk of developing type 2 diabetes, decrease your risk for obesity, and potentially decrease your risk for coronary artery disease.
- Pre-Pregnancy weight: aiming to be at your pre-pregnancy weight by 12 months postpartum can reduce risk of cardiovascular disease, and help with the implementation of an active lifestyle and healthy food consumption. We’re not talking about getting to an unrealistic BMI or weight, just aiming to get back to what you were pre-pregnancy!
- Considering future pregnancies: people who experienced complications in their pregnancy are at a higher risk of complications in future pregnancies. We recommend talking to your care provider about how you can reduce that risk in between pregnancies, most of which will be following the topics we just discussed, but also for any subsequent pregnancies.
- Long term screening: in relation to the above, reach out to a primary care provider for support. Some people should be followed by specialists due to severe complications of pregnancy including; heart failure, heart valve issues, abnormal heart rate issues such as atrial fibrillation, but most follow up can and should be done with your family doctor or nurse practitioner. At approximately 6 months postpartum, we recommend having a blood pressure, height and weight check, as well as some blood work done. This would include doing a sugar screen, cholesterol screen, and kidney screen. We then use this information to calculate a risk score for long term cardiovascular health.
We hope you find this quick overview of disorders in pregnancy, their potential long-term effects, and what you can do to reduce the risk - but be sure to tune into today’s episode where Drs. Sarah & Alicia to into more detail and provide tips with regards to bolstering a healthier lifestyle, including considerations for marijuana consumption, what you can do between pregnancies to rescue the risk, mindfulness smoking cessation tips, and how to implement exercise postpartum. Be sure to also check out Your Nourished Pregnancy Bootcamp from Nourished Beginnings and use the code SFH20 to get 20% off, and if you’d like a deeper dive, you can get The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma by Bessel Van Der Kolk in hard copy or the ebook on audible here!
Subscribe to The Pregnancy to Parenthood Podcast Series! For the low, one-time cost of $47, get full access to over 40 informative episodes supporting you week by week, focused on the trimester and stage of pregnancy you are in. Tune in every week, or binge listen all at once and come back to the episodes you found most helpful as you move through pregnancy to parenthood!
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