Washington, DC -- The incidence of heart attacks during pregnancy, labor and delivery, and the postpartum period, while relatively rare, has risen slightly over the past decade, according to research published in the March issue of Obstetrics & Gynecology. Researchers suggest that the incidence of heart attacks among pregnant women may increase as more women with high-risk factors become pregnant, including those with chronic hypertension, diabetes, eclampsia, preeclampsia, and advancing maternal age.

Researchers from the University of California-Davis studied state data on nearly all births and maternal hospital discharges in the state of California for the years 1991 to 2000. They found 151 cases of heart attacks (either during pregnancy, labor and delivery, or six weeks postpartum) among a population of approximately 5.4 million pregnancies, for a decade average of one heart attack for every 35,700 pregnancies. This incidence rose from one heart attack for every 73,400 pregnancies at the beginning of the study to one heart attack for every 24,600 pregnancies in the final year.

The majority of heart attacks (59%) were diagnosed during pregnancy or labor and delivery. While only 7.3% (11) of women overall died from heart attacks, all of these women had a heart attack during pregnancy or labor and delivery. Women who had a heart attack were more likely to have had previous deliveries. Most striking, say the researchers, was the fact that all types of hypertension (either preexisting or pregnancy-related) were significantly increased among women who had heart attacks. Also noteworthy, 7% of women who had heart attacks were older than 40 and 66% were older than 30.

The researchers say that physicians should be aware of the heart attack risk factors among pregnant women, including chronic hypertension, diabetes, eclampsia, and preeclampsia, and that they should potentially perform diagnostic testing on them to identify and potentially treat them. They add that more women are becoming pregnant in their 50s, placing them at even greater risk of heart attack.

Contact: Heidi E. Ladner, MD, St. Lukes Roosevelt Hospital Center, New York, NY, at heladner@msn.com.

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