Pregnant women with pre-eclampsia at greater risk of heart attack or stroke: What are the signs and symptoms?

Pregnant women with pre-eclampsia have a higher likelihood of heart attack and stroke in later years, new research has suggested.

The study, of more than one million pregnant women, published in the European Journal of Preventive Cardiology, found that the risks remain elevated more than 20 years later.

Pre-eclampsia is a potentially seriously complication of pregnancy, which is thought to affect up to 6% of pregnancies, with severe pre-eclampsia developing in around 1-2% of UK pregnancies.

Symptoms include severe headache, stomach pain and nausea.

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While previous research has established that pre-eclampsia predisposes women to an elevated likelihood of cardiovascular disease later in life, the new research examined how soon after pregnancy the heart attacks and strokes could potentially manifest, and the extent of the risks in different age groups.

Researchers looked at the health records of more than a million pregnant women in Denmark between 1978 and 2017.

The results revealed that overall women with pre-eclampsia were four times more likely to have a heart attack and three times more likely to have a stroke within 10 years of delivery than those without pre-eclampsia.

The risk of heart attack or stroke was still twice as high in the pre-eclampsia group more than two decades after giving birth compared to unaffected women.

The differences in risk became apparent seven years after delivery.

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Commenting on the findings study author, Dr Sara Hallum from the University of Copenhagen, Denmark, says the early onset means preventative treatment for cardiovascular disease should start within a decade of giving birth.

"The high risk of cardiovascular disease after pre-eclampsia manifests at young ages and early after delivery," she explains.

"This indicates that interventions to prevent heart attacks and strokes in affected women cannot wait until middle age when they become eligible for conventional cardiovascular screening programmes."

The research comes as it was previously revealed pregnant women could soon benefit from life-saving blood tests, recommended by the National Institute for Health and Care Excellence (NICE), that can help diagnose suspected preterm pre-eclampsia.

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While tests have previously only been recommended to help rule out pre-eclampsia, these new checks, suggested for use on the NHS, would be able to help midwives diagnose the condition.

Four blood tests that can be used between 20 to 37 weeks of pregnancy have been recommended, which measure levels of placental growth factor (PLGF) in the blood. PLGF is a protein that helps the development of new blood vessels in the placenta, which oxygen and nutrients pass through to the baby.

In pre-eclampsia if PLGF levels are abnormally low this could be an indicator the placenta is not developing properly. But with midwives now able to pre-empt the condition in this way, along with other checks, they can take appropriate action such as making a referral to a specialist and hospital admission to monitor the mother and unborn baby.

What is pre-eclampsia?

According to the NHS, pre-eclampsia is a condition that affects some pregnant women, usually during the second half of pregnancy (from 20 weeks) or soon after their baby is delivered.

Early signs of pre-eclampsia include having high blood pressure (hypertension) and protein in your urine (proteinuria).

In some cases, further symptoms can develop, including:

• severe headache

• vision problems, such as blurring or flashing

• pain just below the ribs

• vomiting

• sudden swelling of the face, hands or feet

While many cases of pre-eclampsia are mild, the condition can lead to serious complications for both mother and baby if it's not monitored and treated, which is why making an earlier diagnosis is so important.

Though most cases of pre-eclampsia cause no problems and improve soon after the baby is delivered, there is a risk the mother can develop life-threatening fits called 'eclampsia', but this is rare.

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Factors that can increase your chances of developing pre-eclampsia include diabetes, high blood pressure, kidney disease, autoimmune conditions and having eclampsia or high blood pressure in a previous pregnancy.

If you notice any symptoms of pre-eclampsia call your midwife, GP surgery or NHS 111 immediately.

If you or someone you know is suffering from pre-eclampsia, or you are worried, you can also call Action on Pre-eclampsia Monday to Friday from 9am to 9pm on 01386 761 848, email info@apec.org.uk, or direct message them on Facebook, Twitter or Instagram.