Is There a Relationship between Adverse Pregnancy Outcomes and Future Development of Atherosclerosis?

Abstract

Cardiovascular disease is one of the main death causes globally. Effective cardiovascular risk management requires a thorough understanding of the mechanisms underlying the disorder. Establishing early markers of the disease allows a timely intervention and prevention of further atherosclerosis development. Multiple studies confirm the correlation between pregnancy disorders and cardiovascular disease in the postpartum period. Moreover, over 30% of women experience adverse pregnancy outcomes. Thus, the examination of the links between these conditions and atherosclerotic cardiovascular disease may help to identify gender-specific risk factors. In this review, we will explore the association between several adverse pregnancy outcome conditions and atherosclerosis. The current analysis is based on the data from several recent studies on the mechanisms behind gestational diabetes, hypertensive disorders of pregnancy, miscarriages, and stillbirths and their implications for the female cardiovascular system.

Keywords: atherosclerosis; cardiovascular risk factors; gestation; pregnancy.

Figure 1

Vascular and metabolic changes during both normal and complicated pregnancies. In a normal pregnancy, the immune system undergoes an anti-inflammatory shift to support the developing fetus. However, complications in pregnancy can lead to a pro-inflammatory state, endothelial dysfunction, and alterations in the placenta. These changes can result in increased blood pressure followed by many pathological conditions associated with the development of pre-eclampsia and hypertension-related pregnancy disorders. Abbreviations: IL—interleukin; LDL-C—low-density lipoprotein cholesterol; PG—prostaglandin; PIGF—placental growth factor; sFlt-1—soluble receptor of PIGF; TC—total cholesterol; TG—triglycerides.

Figure 2

Maternal cardiovascular complications in pregnancy: a comprehensive scheme.