The obstetrician's role in preventing cardiometabolic disease

Abstract

Key content Cardiovascular diseases are the leading causes of death in women and account for the majority of deaths in women living in the UK. Pregnancy is a ‘stress test’ for cardiometabolic conditions, identifying women at increased risk during and after pregnancy. Antenatal and postnatal care may therefore be key times for primary and secondary prevention. Given the growing burden of cardiometabolic diseases, pressure is mounting to integrate screening, management and preventive programmes into maternity services. Learning objectives To be familiar with the long‐term consequences that can follow gestational diabetes and hypertensive diseases of pregnancy. To understand the evidence for interventions before and after birth to prevent future morbidity and mortality. To recognise the important role of obstetricians in linking secondary care with primary and preventive care services to prevent cardiovascular and metabolic diseases. Ethical issues What is the role of the obstetrician in contributing to women's lifelong wellbeing?

A community-based intervention to improve screening, referral and follow-up of non-communicable diseases and anaemia amongst pregnant and postpartum women in rural India: study protocol for a cluster randomised trial

“…Globally, and in India, non-communicable diseases (NCDs) are women’s leading causes of death, and practical strategies are urgently needed to prevent premature mortality and morbidity [ 2 , 3 ]. Complications that develop during pregnancy can identify women at increased risk for NCDs in the months and years following birth [ 4 ]. For example, hypertensive disorders of pregnancy (HDP), including gestational hypertension and preeclampsia, identify women at double the background risk for premature cardiovascular diseases [ 5 ], with around one in three women identified with an HDP having hypertension within the years immediately after birth, the leading risk factor for premature stroke [ 6 ].…”