Obesity: A 'Double Hit' in Pregnant Women With Heart Disease
Being obese and pregnant raises the risk for cardiac complications in women with preexisting heart disease, new research suggests, highlighting the need for earlier interventions in this high-risk population. The analysis of 790 pregnancies revealed that 23% of women with obesity, defined as body mass index greater than 30 kg/m2, had a cardiac event during pregnancy vs 14% of women with normal body weight (P = .006). The difference was driven largely by an increase in heart failure (8% vs 3%; P = .02), although arrhythmias also trended higher in obese women (14% vs 10%; P = .19). Nearly half of the women with obesity and a cardiac event presented in the postpartum period (47%). In multivariate analysis, both obesity and Canadian Cardiac Disease in Pregnancy Study (CARPREG) II risk score were independent predictors of cardiac events (odds ratios for both, 1.7).
@raima The findings are concerning given the rising prevalence of obesity worldwide. National data from 2018 show that slightly more than half of women who gave birth in the United States were significantly overweight or obese before becoming pregnant. Similarly, in the present analysis of 600 women in the CARPREG study who gave birth from 2004 to 2014, nearly 1 in 5 pregnancies (19%) occurred in women with obesity and 25% were in overweight women.