For decades, doctors informed women that preeclampsia was temporary, even though women might get very sick. However, recent research suggests that not only are preeclamptic mothers more prove to heart attack, stroke and its other related problems, but the offspring of these pregnancies  stand a higher  risk for these diseases as well. Sade Oguntola reports.

It seemed like a normal day for Mrs Hannah Alonge, despite her protruding tummy, back pains and swollen feet and legs. In no way did she realise that she might be asked to observe bed rest at the state’s hospital.

Mrs Alonge had a hospital appointment to find out what was wrong with her since the swollen feet and legs started almost two weeks ago. Within the 10-minutes of seeing her doctor and with the results of her urine test, which was almost orange, as well as her weight and the blood pressure readings, she was diagnosed to have pre-eclampsia.

Pre-eclampsia is a serious condition where abnormally high blood pressure and other disturbances develop in the second half of pregnancy, but it can develop any time in the second half of pregnancy, including during labour or even after delivery (usually in the first 48 hours). It affects about 5 per cent of all first-time pregnancies and is dangerous for both mother and child.

Pre-eclampsia can range from mild to severe, and it can progress slowly or rapidly. The only way to get better is to deliver the baby. The more severe the condition and the earlier it appears, the greater the risks both for the pregnant woman and her unborn child. Most women who get pre-eclampsia develop a mild version near their due date, and they and their babies do fine with proper care.

But when pre-eclampsia is severe, it can affect many organs and cause serious or even life-threatening problems, thus the reason, medical doctors always want such pregnant women to deliver early when the condition is severe or getting worse.

Pre-eclampsia causes the blood vessels to constrict, resulting in high blood pressure and a reduced blood flow that can affect organs in the body, such as the liver, kidneys, and brain. When less blood flows to the womb, it can mean problems for the baby, such as poor growth, too little amniotic fluid and placental abruption (when the placenta separates from the wall of the womb before delivery). In addition, the baby may end up being born prematurely.

For decades, doctors informed women that pre-eclampsia was temporary. Even though women might get very sick, after delivery, the healing process is set in motion quickly enough for their bodies to heal.  Usually, they are expected to recover completely. Although their babies may have been affected by the resulting prematurity, the pre-eclampsia itself was not confirmed to cause any direct health concern to the children either because it is considered “transient.”

However, recent research suggests that not only are pre-eclamptic mothers more likely to have heart problems and its related problems (cardiovascular diseases), even the offspring of these pregnancies may turn out overweight or obese and have higher blood pressure readings, and as such be at higher risk for heart disease than children born to women with normal blood pressure - pregnancies. 

Researchers, reporting in the journal Paediatrics, observed that being born to women with pre-eclampsia was associated with significant increases in systolic and diastolic blood pressure and body mass index (BMI) in childhood and adulthood.

According to them, if the systolic blood pressure difference is maintained into adulthood, it would be associated with about an 8 per cent increased risk of death from ischemic heart disease and a 12 per cent increased risk of stroke.

The study, which surveyed data on 45,249 patients, considered traditional risk factors (including blood pressure, cholesterol and blood sugar levels, weight, and body mass index, were recorded before pregnancy) in children exposed to preeclampsia. These babies were born close to term and as such were likely to be from mothers with less severe pre-eclampsia.

Is pre-eclampsia an indicator of women or children predisposed to develop heart disease? Or does it cause damage that result in this long term impact? Genetics may provide part of the explanation. Women who develop pre-eclampsia often have genes that make them more likely to develop chronic hypertension than the average population. Since chronic hypertensives pass their genes on to their children, their children would likewise have a higher risk for hypertension and related problems.   

Still yet studies published in the British Medical Journal theorised also that pre-eclampsia and cardiovascular diseases such as heart attack and stroke may share common causes or mechanisms. The first study found that women who have had pre-eclampsia during pregnancy had an almost four fold increased risk of high blood pressure (hypertension) and a two-fold increased risk of ischaemic heart disease, stroke, and blood clots (venous thromboembolism) in later life.

The second indicated that women with cardiovascular risk factors that are present years before pregnancy may be predisposed to pre-eclampsia.

These results show that unfavourable cardiovascular risk factors that were present years before pregnancy are strong predictors of pre-eclampsia, suggesting that pre-eclampsia and cardiovascular diseases may share a common origin, the authors of the study said.

However, they concluded that this does not rule out the possibility that the pre-eclamptic process itself may also contribute to subsequent cardiovascular risk.

Nevertheless, Dr Adebola Roberts, a consultant obstetrics and gynaecologist, University College Hospital (UCH), Ibadan, Oyo State, stated that once a woman had suffered pre-eclampsia, such stands a higher risk of developing cardiovascular diseases such as stroke and heart problems later in life.

According to Dr Roberts, considering that the exact cause of pre-eclampsia is not known, a woman might not be able to prevent having the disease.

He stated: “Since the cause of pre-eclampsia is unknown, prevention is totally impossible. The only thing that women can do is to make sure that they attend proper antenatal care, such that if the condition is detected early, it could be managed to reduce its attendant morbidity and mortality.

“The major complication of preeclampsia is the development of eclampsia in pregnancy, which is the addition of convulsions or fits in the patients who had suffered preeclampsia.”

So what can mothers do about their babies becoming at increased risk for heart disease?  No doubt, so many factors can affect children that parents do not have control on. But some are adjustable. These includes such things as intake of good diet and exercise choices, smoking, and regular medical checkups and follow up with appointments as necessary.

Much as there are no data suggesting women with a history of pre-eclampsia, or their children, need aggressive monitoring or treatment, but they do need to be followed as at risk, and supported in healthy lifestyles.

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