Spring 2003
The Heart of a Pregnant Woman

Expert physicians in the Birthplace and the Heart Institute at Bridgeport Hospital have teamed up to conduct an important study of pregnancy, obesity, and the heart. If you’re in your first trimester, you can join Bridgeport Hospital experts, and play a part in advancing medical knowledge!

Ana Orsini's son, Tiyane Avant, was born on March 25.
Lakin Shostak's son, William Hughes, was born on March 20.

Lakin Shostak is not overweight. Still, she is taking part in a Bridgeport Hospital pilot study designed to learn about the effects of pregnancy on the hearts of obese women. A physician assistant in Bridgeport Hospital’s Birthplace, Lakin volunteered to be in the control branch of the study—consisting of women who are not obese—because she understands the importance of research.

Ana Orsini, another study participant, has reasons that are closer to home. Before her pregnancy, Ana weighed 370 lbs. When her obstetrician, Emily Blair, MD, told her about the PATH (Pregnancy and the Heart) pilot study, she was eager to take part—"…for my own benefit," she says. "I had a 19-year-old cousin who died of a heart attack, and my 11-year-old cousin already has a pacemaker. I wanted to find out how my heart is doing throughout my pregnancy."

Why Bridgeport Hospital?

It’s not surprising that Bridgeport Hospital is conducting this study. As a local leader in both cardiology and maternity care (Bridgeport Hospital was recently ranked #1 in Connecticut for cardiac interventions, and The Birthplace is a regional center for high-risk pregnancies and births), our team of experts is dedicated to finding new ways to provide the best care.

So when deciding where to give birth, women who choose Bridgeport Hospital know that they will benefit from the knowledge of the expert physicians and staff in The Birthplace. Knowledge that continues to grow thanks to efforts like the PATH study.

"It is imperative for physicians and researchers, to learn more about how an overweight woman’s heart functions during pregnancy," says Steven Laifer, MD, chief of Obstetrics at Bridgeport Hospital and the principal investigator in the study. "We can’t just assume that it reacts in the same way as a lean woman’s heart does. But there are no studies on this subject to tell us exactly how it does react."

That's why Dr. Laifer applied for, and received, a grant from the American Heart Association to conduct the PATH pilot study, in conjunction with Stuart Zarich, MD, chief of Cardiology at Bridgeport Hospital. (A pilot study is a small study that takes place over a short period of time, to determine whether a larger, longer study would provide useful information.) The study is designed to focus on the possible short- and long-term consequences to the mother, including congestive heart failure and permanent heart problems.

Learning more about the effects of pregnancy on an obese woman’s heart is an important starting point for saving lives. Pregnant women who are obese are more likely to have high blood pressure, diabetes, blood clots, and postoperative infections. They are more likely to require cesarean sections, and their weight can make it difficult to provide anesthesia for pain management. Their infants are more likely to have birth defects or be stillborn.

"There is an absolute epidemic of obesity in America," says Dr. Laifer. In fact, according to statistics from the National Institutes of Health, about 28% of women aged 20-39 (in other words, of childbearing age) are obese. Obesity is defined as a Body Mass Index of greater than 30.

Any Woman’s Heart
"Pregnancy has a dramatic effect on the heart of any woman, no matter what her weight," explains Dr. Laifer. To begin with, the amount of blood in the mother’s body increases to help nourish the baby. This increases the heart’s workload. The result is that:

  • The heart pumps faster.
  • The heart pumps harder.
  • The heart grows larger.

In most women, these changes disappear after the child is born. Is this also true for women who are seriously overweight? Or do these women continue to experience changes in their heart function? The results of this pilot program, and of planned future studies, may be useful in finding answers to some important pregnancy-related health questions, and sets the stage for further investigation. Should an obese woman attempt to lose weight before or during her pregnancy? If an obese woman’s heart can’t make the changes that are needed, how can her physicians safely manage her pregnancy and delivery?

Answers to questions like these are important because "obesity is rapidly becoming one of the most common medical complications in our pregnant patients," points out Ronika Choudhary, MD, a resident physician at Bridgeport Hospital who is helping to recruit participants for the study.

Would You Like to Take Part in the PATH Study?

Both obese and non-obese pregnant women who have not yet reached their 16th week are needed to take part in the PATH study. (Lifestyle information—smoking history, etc.—from the non-obese branch of the study will be matched to those from the obese branch for more accurate study results.)

Participation in the study involves four echocardiograms of the heart. This painless, safe procedure uses ultrasound to view and measure the structure and functioning of the heart to diagnose abnormalities and disease. Echocardiograms will be performed three times during pregnancy and once three months after birth, to record changes in the heart.

There is no charge for the echocardiograms, and participants will receive a gift certificate for their assistance.

To find out if you qualify to take part in the PATH study, call Maggie Farina, 384-3990. This could be your chance to learn more about your own heart, and to join Bridgeport Hospital’s experts in helping the hearts of hundreds o