Adverse pregnancy outcomes, including preeclampsia, are associated with an estimated two- to fourfold increased risk of future cardiovascular or cerebrovascular events compared with unaffected women.
Pregnancy acts as a physiological stress test, where adverse pregnancy outcomes like preeclampsia and peripartum cardiomyopathy reveal or contribute to long-term cardiovascular risk, requiring lifelong cardiovascular monitoring and prevention strategies.
Cardiovascular disease (CVD), including hypertensive disorders of pregnancy (HDP) and peripartum cardiomyopathy, is a leading cause of pregnancy-related death in the United States. Women who are African American or American Indian/Alaskan Native, have HDP, are medically underserved, are older, or are obese have a major risk for the onset and/or progression of CVD during and after pregnancy. Paradoxically, women with no preexisting chronic conditions or risk factors also experience significant pregnancy-related cardiovascular (CV) complications. The question remains whether substantial physiologic stress on the CV system during pregnancy reflected in hemodynamic, hematological, and metabolic changes uncovers subclinical prepregnancy CVD in these otherwise healthy women. Equally important and similarly understudied is the concept that women's long-term CV health could be detrimentally affected by adverse pregnancy outcomes, such as preeclampsia, gestational hypertension, and diabetes, and preterm birth. Thus, a critical life span perspective in the assessment of women's CV risk factors is needed to help women and health care providers recognize and appreciate not only optimal CV health but also risk factors present before, during, and after pregnancy. In this review article, we highlight new advancements in understanding adverse, pregnancy-related CV conditions and will discuss promising strategies or interventions for their prevention, diagnosis, and treatment.
Varagić et al. (Tue,) conducted a review in Pregnancy-related cardiovascular disease. Adverse pregnancy outcomes (e.g., preeclampsia, gestational diabetes) vs. Unaffected pregnancies was evaluated. Adverse pregnancy outcomes, including preeclampsia, are associated with an estimated two- to fourfold increased risk of future cardiovascular or cerebrovascular events compared with unaffected women.