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Mothers of children with birth defects have an increased risk of heart attacks

A major new study shows that in the years after giving birth to a child with serious birth defects, the child’s mother has an increased risk of suffering a blood clot in the heart and other forms of heart disease. A researcher from Aarhus University suggests a possible solution.

Being the mother of a child with serious birth defects is so hard that it can have significance for the heart. In a new and comprehensive register-based study, researchers from Aarhus University have worked with other researchers to make a correlation between this life-changing event and an increased risk of suffering a cardiovascular disease such as a blood-clot.

In the study, which has been published in the scientific journal JAMA Network Open, the researchers analysed data from nearly 43,000 mothers of children born with serious birth defects between 1979 and 2013. The researchers have followed the women for 35 years after giving birth. For women in general, fewer than six per cent develop heart disease.
However, in the case of the mothers of children with birth defects, there was a fifteen per cent higher risk of suffering from heart disease compared to women with normally developed children. The figure increases to 37 per cent if the child is born with multiple serious birth defects.

"Having a child with serious birth defects is stressful. These mothers must suddenly live with a long-term source of worry and a status of carer – perhaps for the rest of their life. Stress often leads to strain on the cardiovascular system and maybe a poorer lifestyle, which is one of the causes of cardiovascular diseases”, says Vera Ehrenstein from the Department of Clinical Epidemiology, which is part of Aarhus University and Aarhus University Hospital.

“Health professionals normally focus on what the health of pregnant mothers means for their children, but in this study our focus goes the opposite way,” she says.

Between two and five per cent of all children are born with serious birth defects, which means that around 3,000 Danish woman end up in the group of woman who are at risk of suffering from cardiovascular disease at a young age.

Stress prevention needed
However, Vera Ehrenstein points out that the good news is that stress is largely preventable.

"If we accept that stress is the most important cause, we can also largely prevent the women from suffering cardiovascular diseases at a young age," she says, pointing to the fact that all mothers benefit from rest and time to themselves, and that this is particularly crucial for this group of mothers.

Furthermore, these mothers should probably have their blood pressure and blood fat levels measured. Information on how lifestyle can help prevent cardiovascular disease should also be given to the mothers.

"This could be e.g. advice about exercise and a healthy diet. As doctors don’t expect women to suffer heart attacks at such an age, there is a risk of overlooking the symptoms," says Vera Ehrenstein.

She adds that it could be interesting to investigate whether such an initiative led to fewer heart attacks among this group of mothers.

“This would be the best way to test whether the theory holds up.”

Similar to earlier research
The study has similarities to research from 2016 which showed a correlation between giving birth to a child with birth defects and increased mortality among the mothers. This helps to support the research results.

"It’s difficult to prove a causal relationship in this type of study as it’s based on existing data collated over many years, but the signal it sends is sound," says Vera Ehrenstein.

The research results – more information

The other researchers from the Department of Clinical Epidemiology are Professor Henrik Toft Sørensen and Associate Professor Erzsebet Horvath-Puho. The main international partners are Professor Eyal Cohen from the University of Toronto, Hospital for Sick Children, Toronto, and Professor Nancy Adler from the University of California.
The study is a population-based cohort study, and the researchers have followed up on the data until 2015.
The study is financed by the Canadian Institutes of Health, the Lundbeck Foundation and the Novo Nordisk Foundation.
Read the scientific article Cardiovascular Disease Among Women Who Gave Birth to an Infant With a Major Congenital Anomaly in JAMA Network Open.

Professor Vera Ehrenstein
Department of Clinical Epidemiology, Aarhus University Hospital and
Aarhus University Hospital
Email: ve@clin.au.dk
Telephone: (+45) 8716 7212