Pregnancy characteristics and women's future cardiovascular health: an underused opportunity to improve women's health?

Janet W Rich-Edwards, Abigail Fraser, Deborah A Lawlor, Janet M Catov

Research output: Contribution to journalArticle (Academic Journal)peer-review

180 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)57-70
Number of pages14
JournalEpidemiological Reviews
Volume36
DOIs
Publication statusPublished - 2014

Keywords

  • Birth Weight
  • Cardiovascular Diseases
  • Causality
  • Comorbidity
  • Diabetes, Gestational
  • Female
  • Fetal Development
  • Fetal Macrosomia
  • Humans
  • Hypertension
  • Incidence
  • Maternal Mortality
  • Parity
  • Pre-Eclampsia
  • Pregnancy
  • Pregnancy Complications
  • Pregnancy Complications, Cardiovascular
  • Premature Birth
  • Risk Assessment
  • Women's Health

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