Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Dec;65(12):883-889.

Pregnancy-related cardiovascular risk indicators: Primary care approach to postpartum management and prevention of future disease

Monica Graves  1 , Kelly Howse  2 , Jessica Pudwell  3 , Graeme N Smith  4
Affiliations
Review

Pregnancy-related cardiovascular risk indicators: Primary care approach to postpartum management and prevention of future disease

Monica Graves et al. Can Fam Physician. 2019 Dec.

Abstract

Objective: To define pregnancy-related cardiovascular risk indicators and their association with developing future cardiovascular disease (CVD), and to provide guidance on how primary care providers can help lower future CVD risk through early identification and intervention.

Sources of information: Primary research sources, systematic reviews and meta-analyses, and clinical review articles.

Main message: Cardiovascular disease is the leading cause of death in women. As underlying CVD risk factors are often present for years before the onset of CVD, it is important to use innovative ways to identify women who should undergo CVD risk screening at a younger age. Pregnancy and the postpartum period afford that opportunity, given that the development of certain pregnancy complications (hypertensive disorders of pregnancy, gestational diabetes mellitus, idiopathic preterm birth, delivery of a baby with intrauterine growth restriction, or placental abruption) can reliably identify women with underlying, often unrecognized, CVD risk factors.

Conclusion: Women with 1 or more of these pregnancy complications should be identified at the time of delivery and have formalized postpartum follow-up, including a thorough history, a physical examination, biochemical screening, counseling around lifestyle modification, and possible therapeutic intervention. The link between pregnancy complications and future CVD affords the earliest opportunity for CVD risk assessment for health preservation and disease prevention.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Reference tool for primary care providers on management of pregnancy-related cardiovascular risk indicators in women in the postpartum period BMI—body mass index; ECG—electrocardiogram; HELLP—hemolysis, elevated liver function, low platelet count; po—by mouth; QHS—once daily at bedtime.
Figure 2.
Figure 2.
Poster tool for patients to increase awareness of pregnancy-related cardiovascular risk indicators in the postpartum period
See this image and copyright information in PMC

References

    1. World Health Organization . The atlas of heart disease and stroke. Geneva, Switz: World Health Organization; 2004. Available from: http://www.who.int/cardiovascular_diseases/resources/atlas/en/. Accessed 2019 Oct 22.
    1. Ray JG. Metabolic syndrome and higher risk of maternal placental syndromes and cardiovascular disease. Drug Dev Res. 2006;67:607–11.
    1. Retnakaran R, Qi Y, Connelly PW, Sermer M, Hanley AJ, Zinman B. The graded relationship between glucose tolerance status in pregnancy and postpartum levels of low-density-lipoprotein cholesterol and apolipoprotein B in young women: implications for future cardiovascular risk. J Clin Endocrinol Metab. 2010;95(9):4345–53. Epub 2010 Jul 14. - PubMed
    1. MacDonald SE, Walker M, Ramshaw H, Godwin M, Chen XK, Smith GN. Hypertensive disorders of pregnancy and long-term risk of hypertension: what do Ontario prenatal care providers know and what do they communicate? J Obstet Gynaecol Can. 2007;29(9):705–10. - PubMed
    1. Williams D. Pregnancy: a stress test for life. Curr Opin Obstet Gynecol. 2003;15(6):465–71. - PubMed