Magee to study pregnancy, heart disease connection

Starting today, Pitt researchers will begin to pull at the strings potentially linking pregnancy complications and heart disease.

The Magee-Womens Research Institute, along with researchers from four other universities and medical centers, will study the link between certain pregnancy complications — such as preeclampsia, preterm birth and gestational hypertension — and heart disease that can occur up to a decade after child birth. In March, the American Heart Association awarded the researchers $3.7 million for the study, which will continue until 2020.

The grant is part of the Go Red for Women Research Network, a cross-institutional network of researchers at Columbia University, Johns Hopkins University, New York University and University of California San Diego, all focused on studying contributing factors to heart disease in women.

According to Carl Hubel, one of the study’s researchers and a Pitt professor, the association between pregnancy complications and heart disease is well known, but no one has investigated the causes for that association.

“We became increasingly intrigued by the fact that women who experienced adverse pregnancy outcomes are at about two- to seven-fold increased risk of heart disease later in their life,” Hubel said.

Each university, which the American Heart Association selected to be a part of the Go Red for Women Research Network, proposed three complementary projects: basic science, clinical research and population studies.

Magee’s projects include using mice to study the mechanisms by which pregnancy complications may actually cause subsequent heart disease. Magee’s study will follow 500 women for eight to 10 years after they deliver children at Magee, according to researcher Janet Catov, associate professor of epidemiology and obstetrics, gynecology and reproductive sciences at Pitt.

According to Catov, the study will compare women’s placentas post-partum to their cardiovascular health eight to 10 years later. She said the decade-old placenta data may provide a window into the mothers’ risks of heart disease.

Principal Investigator Robert Powers said the researchers can genetically manipulate mice to create a model of preeclampsia, a common pregnancy complication characterized by high blood pressure and protein in urine, then follow the mice from pregnancy to old age.

“There are a lot of known cardiovascular disease risk factors that likely increase the risk of adverse pregnancy outcomes, but they also increase the risk of cardiovascular disease later in life,” Powers, an associate professor of obstetrics, gynecology and reproductive sciences and cell biology, said. “What we don’t know, because it’s not all or nothing, is whether the adverse pregnancy in and of itself contributes to vascular dysfunction after pregnancy is over.”

According to Hubel, the Go Red for Women network will give researchers a diverse data set, since each participating university is studying a different aspect of women’s cardiovascular health.

“We think there could be incredible cross-fertilization,” Hubel said.

He said UPMC decided to focus on the link between pregnancy and heart disease because, clinically, pregnancy is highly informative. Because young women seek in-depth health care during their pregnancies, and because pregnancy puts pressure on the heart in general, it’s a good time for researchers to analyze women’s health, Hubel said.

He compared pregnancy to jogging on a tilted treadmill, referring to the stress it has on the heart.

According to Catov, pregnancy is a great opportunity to screen a woman’s health and begin to improve health long term.

“We’re really hopeful that we’ll be able to find factors that can be identified at pregnancy that will identify women who are on a high risk trajectory to heart disease,” Catov said. “So that we can begin interventions that can delay, or even prevent, progression to disease.”