The impact of maternal cardiovascular risk factors and diseases on offspring cardiovascular health

The increasing number of pregnancies among women at cardiovascular risk or with established cardiovascular diseases (CVDs) has become a major global health concern because of its lasting influence on the health of their offspring. Maternal heart disease, hypertension, diabetes, obesity, and abnormal lipid levels, including also elevated lipoprotein(a), can disturb fetal growth and development, leading to changes in the heart, blood vessels, and metabolism that raise the risk of CVD problems in childhood and later life. The rising age of pregnant women, especially in the developed countries, also increases this risk. These effects result from a combination of inherited traits and alterations in the intrauterine environment, including impaired blood flow, inflammation, oxidative stress, and disrupted nutrient transfer through the placenta. Such disturbances can modify the structure and function of the developing cardiovascular system and contribute to lifelong vulnerability to CVDs. Studies from large populations show that children born to mothers with cardiovascular conditions have about twice the risk of developing CVD compared with those born to healthy mothers. Good maternal health before and during pregnancy, supported by balanced nutrition, regular physical activity, and effective control of blood pressure, lipids, body weight, and blood sugar, is strongly linked to better outcomes for both mother and child. Although current lifestyle interventions in pregnancy have shown promising effects on maternal wellbeing, their influence on the long-term cardiovascular health of the offspring remains uncertain. Strengthening preconception care, well-designed healthcare education, improving cardiovascular screening in women of reproductive age, and promoting heart-healthy habits across the life course are essential to prevent the transfer of cardiovascular risk from one generation to the next.