What is the clinical evidence from this study?

Study design: Review. Population: Cardiometabolic disorders in pregnancy.

March 20, 2020Open Access

Cardiometabolic Risk Factors in Pregnancy and Implications for Long-Term Health: Identifying the Research Priorities for Low-Resource Settings

Key Result

Pregnancy complications such as hypertensive disorders and gestational diabetes are independent risk factors for future cardiometabolic disorders, necessitating early detection and community-level interventions in low-resource settings.

Structured PICO

Population

Pregnant women at increased risk of cardiometabolic disorders (CMDs) due to pregnancy complications such as hypertensive disorders of pregnancy (HDPs) and gestational diabetes mellitus (GDM) in low-resource settings (LMICs).

This review highlights key research priorities for addressing cardiometabolic risk in pregnancy in low-resource settings, emphasizing community-level interventions, life-course approaches, and improved access to treatments.

Limitations

Insufficient data on the life-long health of women living in low- and middle-income countries
Lack of consolidated criteria for testing and diagnosis of gestational diabetes mellitus in rural settings
Significant socio-cultural barriers affecting compliance to lifelong treatment

Abstract

Cardiometabolic disorders (CMDs), including ischemic heart disease, stroke and type 2 diabetes are the leading causes of mortality and morbidity in women worldwide. The burden of CMDs falls disproportionately on low and middle-income countries (LMICs), placing substantial demands on already pressured health systems. Cardiometabolic disorders may present up to a decade earlier in some LMIC settings, and are associated with high-case fatality rates. Early identification and ongoing postpartum follow-up of women with pregnancy complications such as hypertensive disorders of pregnancy (HDPs), and gestational diabetes mellitus (GDM) may offer opportunities for prevention, or help delay onset of CMDs. This mini-review paper presents an overview of the key challenges faced in the early identification, referral and management of pregnant women at increased risk of CMDs, in low-resource settings worldwide. Evidence-based strategies, including novel diagnostics, technology and innovations for early detection, screening and management for pregnant women at high-risk of CMDs are presented. The review highlights the key research priorities for addressing cardiometabolic risk in pregnancy in low-resource settings.

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