Substance abuse increases risk of heart attack and stroke during pregnancy.
Substance abuse increases risk of heart attack and stroke during pregnancy.
Substance Abuse and Pregnancy: A Dangerous Combination with Serious Health Risks
Substance abuse and pregnancy may seem like a dangerous combination, and new research confirms the serious health risks associated with it. Pregnant women with a history of substance abuse face a dramatically increased risk of death from heart attack and stroke during childbirth compared to women with no drug history.
The study, led by Dr. Martha Gulati, associate director of the Barbra Streisand Women’s Heart Center at the Smidt Heart Institute at Cedars-Sinai in Los Angeles, reveals that substance use during pregnancy doubled the occurrence of cardiovascular events and maternal mortality during delivery. It also doubled the risk of acute heart failure.
The researchers examined various substances, including cocaine, opioids, alcohol, amphetamine/methamphetamine, and cannabis, and found that each substance posed different risks.
Amphetamine/methamphetamine had the strongest association with acute heart failure, increasing the risk by nine times. These drugs were also linked with a 7.5 times greater risk of acute heart attack, a seven times higher risk of cardiac arrest, and triple the risk of maternal death. These substances are known to increase heart rate and blood pressure and cause structural and electrical changes in the heart.
Cocaine, on the other hand, had the strongest association with stroke and was also linked with abnormal heart rhythms called arrhythmias. Opioid use showed the strongest association with infection of the heart valves, known as endocarditis, as these drugs are usually injected into the bloodstream. Alcohol use was associated with the highest risk for arrhythmias.
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Interestingly, cannabis was not associated with maternal death but was associated with double the risk of heart attack. Dr. Gulati emphasizes the need for awareness regarding the risks cannabis poses during pregnancy as it causes heart cell death and can lead to severe cardiovascular events.
The research team analyzed data from a nationwide database of over 60 million hospitalizations for deliveries between 2004 and 2018. They found that substance use complicated more than 955,000 of those deliveries, with women experiencing heart attack, stroke, arrhythmia, endocarditis, acute cardiomyopathy, heart failure, and cardiac arrest.
Given the alarming findings of this study, Dr. Christine Albert, chair of cardiology at the Smidt Heart Institute, emphasizes the need for additional medical care for pregnant women with substance use. Prenatal care for women with a history of substance abuse should involve high-risk pregnancy specialists and cardiologists who can help identify and minimize adverse outcomes.
To ensure the well-being of pregnant women and their children, substance abuse should be considered an independent risk factor for cardiovascular events in pregnancy. This research highlights the urgent need for increased awareness, support, and intervention for women struggling with substance abuse during pregnancy.
The study’s findings were published in the October issue of the Journal of the American College of Cardiology: Advances.
For more information on heart health and pregnancy, you can refer to the U.S. National Institutes of Health.
Sources:
- Cedars-Sinai, news release, Sept. 18, 2023
- U.S. National Institutes of Health – Heart Health and Pregnancy
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