Caring for 2 hearts: Experts talk about heart problems during pregnancy and how mums-to-be can stay healthy

First-time mummies feel excitement like no other, especially when they find out about the pregnancy. You go through many emotions and there’s perhaps a smidgen of anxiety and tonnes of planning involved in the process.

But in order to prepare for the arrival of your little one, you shouldn’t cross out the possibility of heart problems during your pregnancy nor ignore the signs.

In fact, in 2020 the Singapore Heart Foundation (SHF) reported that cardiovascular disease was the single largest cause of female mortality and accounts for one-third of all deaths among women worldwide. Pregnant women especially face a greater risk of developing heart problems. 

To commemorate this year’s World Heart Day and National Heart Week, theAsianparent reached out to Dr Chan Wan Xian, Chairman of Singapore Heart Foundation’s Go Red For Women (GRFW) Campaign, and SHF Dietitian, Natalie Yeo.

Heart problems during pregnancy and why you should be worried

According to Dr Chan, the mortality due to heart diseases during pregnancy – is increasing. She adds that in developed countries heart disease is now the leading cause of maternal deaths.

Heart disease complicates between one per cent and four per cent of pregnancies, and accounts for up to 15 per cent of maternal deaths. The condition is also expected to become a greater contributor to maternal complications and deaths worldwide.

This is due to improved survival of women with congenital heart disease and an increasing number of women with cardiovascular risk factors such as:

• Hypertension
• Diabetes
• Smoking
• Hyperlipidemia
• Weight issues (obesity)

Besides congenital heart diseases, the most common presentations of heart diseases during pregnancy and the postpartum period include the following:

• Heart failure
• Myocardial
• Infarction (heart attack)
• Arrhythmia
• Aortic dissection

Heart problems during pregnancy the signs and symptoms

To be better informed about the symptoms of heart problems during pregnancy, Dr Chan lists down the signs to look out for:

• Shortness of breath and associated decreased in effort tolerance
• Extreme fatigue
• Chest pain
• Palpitations, especially when there is associated fainting spells
• Fainting spells, involving loss of consciousness

Dr Chan also shared factors that increase the risk of heart diseases during pregnancy and adds that these are most commonly seen in women with:

• Pre-existing medical conditions including hypertension, diabetes, thyroid disorders, autoimmune disorders and renal disease
• Pre-existing heart disease such as congenital heart disease, heart failure, heart attack, stroke and arrhythmias
• Prior heart valve surgery and had mechanical heart valve prosthesis
• Smoking

Heart problems during pregnancy: How women experiencing the signs can manage their health

For women experiencing symptoms 

“Women who experience any symptoms during the gestation period which may be linked to heart conditions should inform their obstetrician and see a cardiologist early for evaluation,” Dr Chan tells theAsianparent.

For women with pre-existing heart disease or any medical conditions

Those with pre-existing heart diseases or any medical conditions should also see an obstetrician or cardiologist for pre-pregnancy assessment and evaluation.

For instance, pregnant women who get diagnosed with cardiovascular disease should continue to follow up with a cardiologist even after delivering their child.

Dr Chan says this is because such heart diseases can still persist even after pregnancy. It could also increase the risks of cardiovascular disease in the future. 

“Continuation of care under a cardiologist would allow for optimal treatment to take place and decrease risks of future cardiac events,” advises Dr Chan.

Tips on how pregnant women can prevent risks of heart problems

Dr Chan shares the following tips on ways to reduce the risk of experiencing heart complications during pregnancy:

• Maintain a heart-healthy lifestyle prior to conception
• Have a balanced diet complete with protein, fruits, vegetables and whole grains
• Continue regular moderate exercises for at least 150 minutes every week
• Stop smoking
• Monitor and keep weight gain during pregnancy within recommended range by an obstetrician
• Get adequate sleep
• Maintain a positive mindset or attitude
• See a doctor early for health risks assessment and to evaluate cardiovascular risks

Healthy eating habits to combat heart problems during pregnancy and the early signs

Since it is important to maintain healthy eating habits to avoid heart problems while pregnant, Ms Natalie Yeo shares some basic dietary guidelines with theAsianparent. 

“Pregnant mothers are more susceptible to infections, which can lead to serious health problems for mother and baby,” says Ms Yeo.

She adds, “A healthy balanced diet that meets nutrient requirements can optimise pregnancy outcomes and assist with the overall growth and development of the fetus.”

Foods to avoid or be mindful of during pregnancy

1. Those with too much fat and sugar

“Limit foods high in saturated fat and trans-fat, fatty cuts of meat, full-fat dairy, baked products, and sugar-sweetened beverages and sweets,” advises Ms Yeo.

2. Raw, uncooked foods

• Unpasteurised soft cheeses or meat spreads
  These foods may be contaminated with bacteria (e.g., Listeria), which may lead to miscarriage and stillbirth. Pregnant ladies are more vulnerable to food poisoning.
• Raw and undercooked meat, eggs, and seafood
  These may also be contaminated with bacteria such as Salmonella, E. coli and Listeria. Ensure that these foods are cooked through and at the right temperature to eliminate bacteria growth. Egg yolks and whites should be cooked thoroughly till solid.

3. Unwashed salads or ready-to-eat salads

Ms Yeo says salads should not be heated and left at room temperature as they may be contaminated with bacteria that can cause food poisoning. Some salad dressings may also contain raw eggs and should be avoided.

4. Fresh juices

While fresh juices are refreshing, pregnant women should instead stick to fresh fruits. This is because such juices may contain harmful bacteria which can then lead to food poisoning, miscarriage and stillbirth. 

5. Large deep-sea fishes

“Avoid fishes that may contain high levels of mercury, such as swordfish, king mackerel, tilefish, bigeye tuna and shark,” notes Ms Yeo. “Consumption of heavy metal could potentially harm the development of the baby’s neurological system.”

6. Alcohol

Alcohol intake may affect fetus development, leading to delayed growth and mental issues such as fetal alcohol syndrome (FAS).

7. Caffeine

For mums who enjoy a cup of coffee, Ms Yeo shares that it is safe to consume, however, in moderation. She advises limiting caffeine intake to 200mg a day, which is equivalent to a maximum of two cups of coffee.

8. Do not diet

Ms Yeo stresses that proper and good nutrition is important for your child’s growth and development. She says, “During pregnancy, the expectant mother’s energy requirements increase by an additional 300kcal a day.”

“Dieting affects nutrient levels and may affect the baby’s development, putting extra strain on the mother’s body,” adds Ms Yeo.

Food to help maintain a healthy heart during pregnancy

According to Ms Yeo, a well-balanced heart-healthy diet is essential in meeting the developmental needs of your baby and to maintain heart health.

“A heart-healthy diet consists of a diet rich in whole grains, fresh fruit and vegetables, lean protein such as fish, legumes, nuts, low-fat dairy products, with healthier vegetable oils,” she tells theAsianparent.

She also says, “A balanced proportion of carbohydrates, fats and protein is essential to meet calorie requirements and needs during pregnancy and maintain a healthy heart.”

To start incorporating healthy eating habits in your pregnancy journey, you can simply follow the SHF Heart Smart Eating Plate:

1. Fibre

Foods that are rich in fibre such as whole grains, fruits and vegetables can help to reduce the risk of cardiovascular disease. They support weight management as they are digested at a slower rate and keep one feeling fuller for longer periods of time.

Ms Yeo also noted that most fruit and vegetables are rich in nutrients and high in soluble fibre which reduces the absorption of cholesterol, thus protecting the body against heart disease.

The Singapore Health Promotion Board recommends consuming at least two to three servings of whole grains daily such as brown rice, quinoa, millet, oats, barley, wholemeal bread.

2. Protein

“Protein is necessary for the growth and repair of tissues in our bodies,” explains Ms Yeo. “Pregnant women require more protein for the formation of fetus organs. Consume protein such as lean meats, poultry, fish and tofu.”

3. Healthy fats (Monounsaturated and Polyunsaturated Fats)

Heart-healthy unsaturated fats such as monounsaturated and polyunsaturated fats can also help in increasing levels of HDL cholesterol in the blood. 

Foods that contain heart-healthy fats are avocado, unsalted nuts and seeds, healthier vegetable oils and oily fish. Research even finds that consuming at least two servings of fish per week can reduce the risk of heart failure, myocardial infarction, sudden cardiac death and death from coronary artery disease.

4. Heart-healthy snacks

Ms Yeo says heart-healthy snacks are those that will provide you and your baby with the nutrients you both need.

Healthier snack options are plain low-fat yoghurt with fresh fruit, low-fat milk or unsweetened/reduced sugar soy milk, unsalted baked nuts, seeds or whole meal crackers.

This article was first published in theAsianparent.