Nurturing Heart Health for Expecting Mothers

Dr. Gwyneth McNeill, a cardiologist with Main Line Health, talks about navigating the cardiovascular risks of pregnancy and what expectant mothers can do to manage them.

›› What made you decide to specialize in cardio-obstetrics? I have always been interested in preventative cardiology. When I learned about cardiovascular risk in women experiencing adverse pregnancy outcomes, I realized my desire to provide care for this specific population of women. If we start cardiovascular disease prevention early, we can reduce the risk of heart attacks, congestive heart failure and other cardiac complications.

›› What are the potential cardiac complications that come with pregnancy? What are some of the risk factors for developing these issues? Hypertensive disorders during pregnancy, such as preeclampsia and HELLP syndrome, a serious complication of high blood pressure during pregnancy, heighten the risk of chronic high blood pressure and cardiovascular diseases, including heart attacks. Additional cardiac complications include gestational diabetes and peripartum cardiomyopathy. Risk factors include chronic hypertension, diabetes mellitus, obesity, and age over 35.

›› What does treatment look like for pregnant women who develop cardiac problems? Ideally, each woman has a cardio-obstetrics treatment team, comprising their OB/GYN, cardiologist, primary care provider, social worker, and specialists as needed. Whether pregnant or postpartum and breastfeeding, I ensure the medications prescribed are safe for both mother and baby, emphasizing collaborative care tailored to individual medical conditions.

›› What disparities and inequities exist in cardiac-obstetrics research and clinical care, and how are they being addressed? Disparities exist in research and care. Women of color, underrepresented in studies, face cultural competency issues and higher maternal mortality rates. Recognizing that Black women face an elevated risk of pregnancy complications and subsequent cardiac events, early cardiovascular prevention is crucial. At Main Line Health, we proactively address these concerns, ensuring mothers have access to medical care, especially postpartum, to address conditions like preeclampsia and cardiac complications post-delivery.

›› Are there long-term risks for women who develop issues like high blood pressure during pregnancy? Yes, there are significant long-term cardiac risks for this population of women. They are four times more likely to develop chronic high blood pressure and twice as likely to experience cardiovascular disease later in life compared to those without pregnancy-related hypertension. Obtaining a comprehensive history is crucial for doctors to assess heart disease risk in female patients and be proactive with their medical care. Together, we can enhance the standard of care and promote better heart health outcomes for women.