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. 2020 Dec;22(12):61.
doi: 10.1007/s11936-020-00862-6. Epub 2020 Oct 31.

The Association of Adverse Pregnancy Outcomes and Cardiovascular Disease: Current Knowledge and Future Directions

Anum S Minhas  1   2   3 , Wendy Ying  1   2 , S Michelle Ogunwole  4 , Michael Miller  5 , Sammy Zakaria  2 , Arthur J Vaught  5 , Allison G Hays  2 , Andreea A Creanga  5   6 , Ari Cedars  3   7 , Erin D Michos  1   2   3 , Roger S Blumenthal  1   2 , Garima Sharma  1   2
Affiliations

The Association of Adverse Pregnancy Outcomes and Cardiovascular Disease: Current Knowledge and Future Directions

Anum S Minhas et al. Curr Treat Options Cardiovasc Med. 2020 Dec.

Abstract

Purpose of review: Adverse pregnancy outcomes are associated with increased risk for future cardiovascular disease. The goal of this review is to share what is currently known about the increased risk and to identify areas for future research.

Recent findings: Severe studies have identified a strong association between adverse pregnancy outcomes and cardiovascular disease such as heart failure, valvular disease, ischemic heart disease, stroke, hypertension, and metabolic syndrome. The recognition of this increased risk is reflected in recent changes in prevention guidelines. The guidelines now recognize sex-specific risks such as preeclampsia and preterm delivery and recommend incorporating a pregnancy history to identify them earlier. However, no robust risk prediction tools incorporating these pregnancy risk factors have been developed and validated. While smaller clinical trials have been performed in reducing cardiovascular risk factors in the postpartum timeframe, there remains a paucity of large-scale randomized clinical trials that continue to show a risk reduction in these women.

Summary: While there is increasing recognition of the long-term cardiovascular risks associated with adverse pregnancy outcomes, there remains a need for interventional studies aimed at reducing this risk and for incorporation of pregnancy risk factors into traditional cardiovascular risk prediction tools.

Keywords: Adverse pregnancy outcomes; Aspirin; Gestational diabetes; Maternal cardiovascular disease; Preeclampsia; Preterm delivery.

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Conflict of interest statement

Conflict of interest Anum S. Minhas, Wendy Ying, S. Michelle Ogunwole, Michael Miller, Sammy Zakaria, Arthur J. Vaught, Allison G. Hays, Andreea A. Creanga, Ari Cedars, Erin D. Michos, Roger S. Blumenthal, and Garima Sharma declare that they have no conflict of interest.

Figures

Fig. 1.
Fig. 1.
Shared risk factors between adverse pregnancy outcomes and cardiovascular disease.
See this image and copyright information in PMC

References

    1. Martin JA, Hamilton BE, Osterman MJK, Driscoll AK. Births: final data for 2018. Natl Vital Stat Rep. 2019;68:1–47. - PubMed
    1. Centers for Disease Control and Prevention. Preterm birth [Internet]. Available from: http://www.cdc.gov/reproductivehealth/maternalinfanthealth/pretermbirth.htm. Accessed 7/11/20.
    1. Lane-Cordova AD, Khan SS, Grobman WA, Greenland P, Shah SJ. Long-term cardiovascular risks associated with adverse pregnancy outcomes. J Am Coll Cardiol. 2019;73:2106–16. - PubMed

    2. This review highlights the epidemiology and possible mechanisms of adverse pregnancy outcomes and future CVD, incorporating recent data.

    1. Kuklina E, Callaghan W. Chronic heart disease and severe obstetric morbidity among hospitalisations for pregnancy in the USA: 1995–2006: heart disease and severe morbidity in USA. BJOG Int J Obstet Gynaecol. 2011;118:345–52. - PubMed
    1. Correa A, Bardenheier B, Elixhauser A, Geiss LS, Gregg E. Trends in prevalence of diabetes among delivery hospitalizations, United States, 1993–2009. Matern Child Health J. 2015;19:635–42. - PMC - PubMed