Heart Health During Pregnancy: Risks & Prevention

Why Heart Health During Pregnancy Deserves Your Attention

When you think about pregnancy health, your heart probably isn't the first thing that comes to mind. But here's a statistic that may surprise you: cardiovascular disease is the leading cause of pregnancy-related death in the United States, accounting for roughly one-third of maternal deaths worldwide.

A 2026 report from the National Academies of Sciences, Engineering, and Medicine found that more than three-quarters of pregnancy-related cardiovascular deaths are potentially preventable. That means awareness, early screening, and proactive care could save lives — including yours.

Whether you're planning a pregnancy, currently expecting, or in the postpartum period, understanding your cardiovascular risk is one of the most important things you can do for yourself and your baby.

How Pregnancy Changes Your Heart and Circulatory System

Pregnancy puts extraordinary demands on your cardiovascular system. Even in a completely healthy pregnancy, your body undergoes dramatic changes to support your growing baby:

Blood volume increases by 30-50% to supply oxygen and nutrients to the placenta and fetus.
Heart rate rises by 10 to 20 beats per minute to pump that extra blood.
Cardiac output increases by 30-50%, meaning your heart works significantly harder than usual.
Blood pressure typically drops in the first and second trimesters before returning to pre-pregnancy levels in the third trimester.

For most women, these changes happen smoothly and resolve after delivery. But for those with underlying risk factors — even undiagnosed ones — the added stress on the cardiovascular system can unmask or worsen heart-related problems.

The Numbers Are Getting Worse

Cardiovascular complications during pregnancy are on the rise in the United States. A review of more than 56,000 pregnancies found troubling trends between 2001 and 2019:

Obesity among pregnant women increased from 2% to 16%
High blood pressure increased from 3% to 12%
Diabetes increased from 1% to 3%

These aren't just numbers on a page. They represent real people facing real risks — and the trend is heading in the wrong direction.

Who Is at Higher Risk for Pregnancy-Related Heart Problems?

While any pregnant person can develop cardiovascular complications, certain factors may increase your risk:

Advanced maternal age: Being 35 or older at the time of delivery is associated with higher cardiovascular risk.
Pre-existing high blood pressure: Chronic hypertension before pregnancy significantly raises the risk of complications.
Obesity: A higher body mass index places additional strain on the heart and is linked to preeclampsia and gestational diabetes.
Diabetes (type 1, type 2, or gestational): Blood sugar regulation issues affect blood vessel health and heart function.
History of preeclampsia: Women who have had preeclampsia in a previous pregnancy face three to four times the risk of developing high blood pressure later in life and double the risk of heart disease and stroke.
Race and ethnicity: Black women have a significantly higher risk of peripartum cardiomyopathy and are often diagnosed later than white women, contributing to worse outcomes.
Family history: A family history of heart disease or cardiomyopathy may increase your personal risk.
Smoking: Tobacco use damages blood vessels and compounds pregnancy-related cardiovascular stress.

Important: Even women with no prior health issues can develop cardiovascular complications during pregnancy. That's why awareness matters for everyone.

Key Cardiovascular Conditions to Know About

Preeclampsia

Preeclampsia is a pregnancy-specific condition characterized by high blood pressure and signs of organ damage, usually affecting the liver or kidneys. It typically develops after 20 weeks of pregnancy and affects about 5-8% of pregnancies.

Warning signs include severe headaches, vision changes, upper abdominal pain, sudden swelling in the face or hands, and protein in the urine. Left untreated, preeclampsia can progress to eclampsia (seizures) or HELLP syndrome, both of which are life-threatening emergencies.

Research shows that women who develop preeclampsia have higher levels of hormones that may also increase their risk of developing peripartum cardiomyopathy. The long-term cardiovascular impact is significant — preeclampsia is now considered a major risk factor for future heart disease.

Peripartum Cardiomyopathy

Symptoms include shortness of breath, extreme fatigue, swelling in the legs and feet, chest pain, and heart palpitations. The challenge is that many of these symptoms mimic normal pregnancy discomforts, which can delay diagnosis.

If you notice that normal activities like climbing stairs or lying flat suddenly make you much more breathless than usual, or if swelling in your legs seems excessive, talk to your healthcare provider immediately.

Gestational Hypertension

Gestational hypertension is high blood pressure that develops after 20 weeks of pregnancy in someone who previously had normal blood pressure. While it doesn't involve the organ damage seen in preeclampsia, it still requires close monitoring because it can progress to preeclampsia.

Warning Signs You Should Never Ignore

During pregnancy and in the postpartum period, contact your healthcare provider immediately if you experience:

Severe or persistent headache that doesn't respond to normal treatment
Vision changes, including blurring, seeing spots, or light sensitivity
Chest pain or pressure
Difficulty breathing or shortness of breath that worsens
Racing heart or heart palpitations
Severe swelling in the face, hands, or legs
Upper abdominal pain, especially on the right side
Sudden weight gain (more than 2-3 pounds in a week)
Fainting or dizziness

Don't dismiss these symptoms as "just pregnancy stuff." While some discomfort is normal during pregnancy, these warning signs deserve prompt medical evaluation. It's always better to call and be reassured than to wait and risk a serious complication.

How to Protect Your Heart During Pregnancy

The good news is that many pregnancy-related cardiovascular complications are preventable or manageable with the right approach:

Before Pregnancy

Get a preconception checkup. Discuss your cardiovascular risk factors with your doctor before you conceive. This is especially important if you have high blood pressure, diabetes, or a family history of heart disease.
Achieve a healthy weight. Reaching a healthy weight before pregnancy may reduce your risk of gestational diabetes, preeclampsia, and other complications.
Manage existing conditions. If you have hypertension or diabetes, work with your provider to optimize your health before becoming pregnant.

During Pregnancy

Attend all prenatal appointments. Regular blood pressure monitoring and urine tests can catch preeclampsia and other issues early.
Stay physically active. The American Heart Association recommends that most pregnant women get at least 150 minutes of moderate-intensity activity per week. Walking, swimming, and prenatal fitness classes are excellent options.
Eat a heart-healthy diet. Focus on fruits, vegetables, whole grains, lean proteins, and healthy fats. The DASH eating plan has been shown to help manage blood pressure and may help prevent hypertensive disorders. A diet rich in quality nutrition supports both your heart and your baby's development.
Monitor your blood pressure at home. If your provider recommends it, tracking your blood pressure between visits can help catch changes early.
Don't smoke or drink alcohol. Both substances increase cardiovascular risk and can harm your developing baby.
Manage stress. Chronic stress raises cortisol and blood pressure. Mindfulness, gentle yoga, deep breathing, and adequate sleep all support cardiovascular health.

After Delivery

Don't skip postpartum follow-up. Data shows that 57% of pregnancy-related deaths occur between seven days and one year after delivery. The postpartum period is critical for cardiovascular monitoring.
Know your numbers. If you had preeclampsia, gestational diabetes, or other complications, ask your provider about long-term cardiovascular screening. These conditions are now recognized as significant risk factors for future heart disease.
Continue heart-healthy habits. The lifestyle choices you make after delivery continue to protect your heart for decades to come.

The Bigger Picture: Why This Conversation Matters

Maternal cardiovascular health has historically been under-discussed and under-screened. But a growing movement in medicine — called cardio-obstetrics — is working to change that by integrating heart care into pregnancy care.

The 2026 National Academies report calls for stronger clinical preventive services, better follow-up after delivery, and improved care coordination across the reproductive life course. New guidelines from the European Society of Cardiology are also empowering women with cardiovascular disease to make more informed decisions about pregnancy.

You deserve to feel empowered, too. Knowing your risk factors, recognizing warning signs, and advocating for thorough cardiovascular screening during and after pregnancy are all steps you can take to protect yourself.

Frequently Asked Questions

Can pregnancy cause heart problems even if I've never had them before?

Yes. The dramatic cardiovascular changes of pregnancy — including a 30-50% increase in blood volume and cardiac output — can unmask previously undiagnosed conditions or create new ones. Research shows that cardiovascular complications during pregnancy are increasing even among people with no prior health issues. That's why regular prenatal monitoring is so important for everyone, regardless of health history.

What is peripartum cardiomyopathy and how common is it?

Peripartum cardiomyopathy (PPCM) is a form of heart failure that develops in the last month of pregnancy or within five months after delivery. It affects approximately 1 in 1,000 to 1 in 4,000 pregnancies in the United States. Symptoms include shortness of breath, extreme fatigue, chest pain, and leg swelling. Because these symptoms overlap with normal pregnancy discomfort, PPCM is sometimes diagnosed late. If your symptoms feel more severe than typical pregnancy fatigue, talk to your provider.

If I had preeclampsia, does that mean I'll have heart disease later?

Having preeclampsia doesn't guarantee future heart disease, but it is a recognized risk factor. Research shows that women who've had preeclampsia face three to four times the risk of developing high blood pressure and double the risk of heart disease and stroke compared to women without a history of preeclampsia. This means you may benefit from more proactive cardiovascular screening and heart-healthy lifestyle habits in the years following your pregnancy.

How soon after delivery should I follow up about heart health?

The standard six-week postpartum checkup is a starting point, but experts increasingly recommend earlier and more frequent follow-up for women with cardiovascular risk factors. Since 57% of pregnancy-related deaths occur between seven days and one year postpartum, ongoing monitoring throughout the first year is important. If you had any pregnancy complications, ask your provider about a cardiovascular screening schedule tailored to your situation.

This article is for informational purposes only and is not medical advice. Consult your healthcare provider before making health decisions.

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