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
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
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,
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
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
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
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