Pregnancy Characteristics and Women's Future Cardiovascular Health: An Underused Opportunity to Improve Women's Health?

Abstract

Growing evidence indicates that women with a history of common pregnancy complications, including fetal growth restriction and preterm delivery (often combined as low birth weight), hypertensive disorders of pregnancy, and gestational diabetes, are at increased risk for cardiovascular disease later in life. The purpose of this paper was to review the associations of parity and these 4 pregnancy complications with cardiovascular morbidity and mortality; to review the role of cardiovascular risk factors before, during, and after pregnancy complications in explaining these associations; and to explore the implications of this emerging science for new research and policy. We systematically searched for relevant cohort and case-control studies in Medline through December 2012 and used citation searches for already published reviews to identify new studies. The findings of this review suggest consistent and often strong associations of pregnancy complications with latent and future cardiovascular disease. Many pregnancy complications appear to be preceded by subclinical vascular and metabolic dysfunction, suggesting that the complications may be useful markers of latent high-risk cardiovascular trajectories. With further replication research, these findings would support the utility of these prevalent pregnancy complications in identifying high-risk women for screening, prevention, and treatment of cardiovascular disease, the leading cause of morbidity and mortality among women.

Pregnancy‐Related Risk Factors Are Associated With a Significant Burden of Treated Hypertension Within 10 Years of Delivery: Findings From a Population‐Based Norwegian Cohort

“…De novo hypertensive disorders of pregnancy and gestational diabetes mellitus (GDM) are recognized as risk factors for premature maternal CVD 2. Evidence has also been accumulating on maternal CVD associated with other pregnancy‐related complications and outcomes,3 such as preterm delivery,4, 5, 6, 7, 8, 9, 10, 11 fetal growth restriction5, 7, 10, 12 placental abruption,13 and pregnancy losses 5, 14, 15, 16…”

Association of Premenstrual Syndrome with Blood Pressure in Young Adult Women

“…Numerous studies have evaluated pregnancy as a ''stress test'' for future cardiovascular health, suggesting that pregnancy-induced hypertensive disorders may predict risk of hypertension and cardiovascular disease (CVD). 5,6 However, because these conditions are rare and, by definition, limited only to women who have had a pregnancy, they have limited utility as a screening tool. Identifying more prevalent reproductive health conditions that are also associated with elevated blood pressure and hypertension risk may have greater public health impact.…”

Hipertensión/preeclampsia postparto, Recomendaciones de manejo según escenarios clínicos, seguridad en la lactancia materna, una revisión de la literatura

“…Con respecto a antihipertensivos y lactancia, en su mayoría son considerados seguros de riesgo muy bajo (nivel 0) y riesgo bajo (nivel 1) (16), la NICE y la guía Canadiense recomienda Alfabetabloqueadores, Calcioantagonistas, IECAS (4,55). Para finalizar se recomienda la consejería preconcepcional y el seguimiento de estas pacientes, debido al riesgo cerebro cardiovascular a largo plazo (57)(58)(59) …”