Maternal Risk Factors, Preterm Birth, and Future Cardiovascular Disease: A Narrative Literature Review

Abstract: Preterm birth (PTB) is a major challenge in public health around the globe. However, little is known about associations among maternal risk factors (mRFs), PTB, and future cardiovascular disease (CVD). This review article discusses the current status of PTB, the side effects of some traditional cultures, and the role of major mRFs related to unhealthy “environmentsleep- emotion-exercise-diet” intervention E(e)SEEDi lifestyle on PTB and future CVD (fCVD). This narrative review and interpretive analysis was based on literature sourced from PubMed using the keywords 'maternal,' 'risk factor,' 'lifestyle,' 'preterm birth,' and 'CVD.' The interpretation of the findings was informed by the author’s extensive clinical experience over the past decades. Data were mainly extracted from about 180 articles listed in the reference section. Totally, there are more than 50 modifiable and non-modifiable mRFs before and during pregnancy (especially 28 weeks to 37 weeks), which may result in PTB and recurrent PTB. In fact, these major mRFs play a pivotal role in the development of fCVD in both pregnancy women and newborns. The origins of fCVD link to not only major mRFs but also other adverse pregnancy outcomes (APO) and adverse neonates outcomes (ANO). Possible mechanisms include increased risk of lipid disorders and atherosclerosis, as well as DNA methylation. Herein, a healthy E(e)SEEDi lifestyle is crucial for controlling and preventing PTB and fCVD, but the underlying mechanisms require further clinical and experimental investigation.