A Window on Risk

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Pregnancy is hard on the body, with 10-15% of women experiencing a complication themselves or with their baby. In some ways, pregnancy is essentially a stress test for the mother, with the potential to forecast significant health risks down the road.

That's particularly true when it comes to heart disease, stroke, high blood pressure and diabetes. Researchers have learned that certain complications experienced during pregnancy can point to a greater risk for those health problems at a much earlier age.

Helping young moms understand this — and get an early start on prevention — is a key driver behind Mother’s Heart Wise, a pilot program at AdventHealth Central Florida. The program aims to identify women who experience certain complications during pregnancy and offer them education and followup care to learn more about ways to protect their health.

“Pregnancy is a unique window into that woman's future risk of having cardiovascular disease,” says Patricia Guerrero, medical director of AdventHealth’s Cardiovascular Wellness and Prevention Program and one of the main designers of the pilot program.

It’s also a narrow window, since the complications often go away in the weeks and months after the child’s birth, as pregnancy stresses fade away. If the mothers don’t get in right away to see a doctor, the opportunity may be lost.

“Oftentimes, their access to medical care is only during pregnancy and immediately post pregnancy,” Guerrero says.

Among the most significant pregnancy complications is high blood pressure, which increases the mother’s risk for heart disease by 67% and the risk for stroke by 83%, according to the American Heart Association. Experiencing type 2 diabetes during pregnancy increases the risk of heart disease by 68%. And while the condition often goes away after the pregnancy, mothers with gestational diabetes have a 10 times greater risk of developing diabetes later.

Potential program participants are identified by their obstetricians during the course of the pregnancy. A nurse navigator then reaches out to the expectant or new mothers by phone or e-mail. They’ll offer to connect them with a primary care doctor or, at least, to send educational materials to help them understand their risks.

One of the more significant challenges faced by the program is overcoming the general tendency of younger people to think of themselves safe from things like heart disease and heart attacks.

The goal is help them understand that “small changes right now can truly have a strong impact on your future,” says Doreen Forsythe, senior nurse manager for the hospital’s Women & Children Health Navigation program.

With the program well into its third year, they’ve learned that it’s often easier to make a connection with the mother before their child is born. “As soon as the baby is born, (their focus) shifts to their newborn care,” Forsythe says. 

Tags: Feature, Economic Backbone: Cardiac Care