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Six pregnancy-related complications – high blood pressure, gestational diabetes, prematurity, gestational birth, loss of pregnancy, or placental abortion – increase a woman’s risk of developing cardiovascular disease (CVD) later in life – The Association’s magazine Circulation was published. The statement calls for vigorous prevention of these risk factors and primary prevention of CVD for women who experience these complications when moving from pregnancy and postpartum care to primary care, and for life-long monitoring of CVD risk continued.

Approximately 10% to 15% of pregnant women experience unfavorable pregnancy outcomes that are maternal or fetal complications, including the six closely linked to subsequent risk of CVD, as well as other measures related to the health of the baby related, such as B. a low birth weight. great gestational age and restriction of fetal growth.

“Adverse pregnancy outcomes are related to women who have high blood pressure, diabetes, abnormal cholesterol, and cardiovascular diseases such as heart attacks and strokes long after they are pregnant,” said Dr. med. Nisha I. Parikh, MPH, Chair of the Scientific Committee for Opinion Writing and Associate Professor of Medicine in the Department of Cardiovascular Disease at the University of California at San Francisco. “Preventing or treating risk factors early on can prevent cardiovascular disease. Therefore, if women and their health professionals use knowledge and use it to improve health, adverse pregnancy outcomes can be an important window for cardiovascular disease prevention use.”

This comprehensive opinion provides an overview of the latest scientific literature on adverse pregnancy outcomes and cardiovascular disease, with a particular focus on health differences, lifestyle and prevention recommendations. “The evidence linking adverse pregnancy outcomes to later cardiovascular disease has been consistent over many years and has been confirmed in nearly every study we examined. This statement should inform future prevention guidelines about the important factors involved in Determining women’s risk for heart disease and stroke should be considered. “Parikh said.

The statement indicates the level of risk associated with several pregnancy complications:

  • High blood pressure during pregnancy, called gestational hypertension, increases a woman’s risk of cardiovascular disease later in life by 67% and the chance of stroke by 83%. Pregnancy hypertension is defined as the blood pressure during pregnancy that is at or above 140/90 mm Hg after 20 weeks of pregnancy in a woman with previously normal readings.
  • Preeclampsia (high blood pressure during pregnancy combined with signs of damage to the liver, kidneys, or other vital organ) is a serious illness and is associated with a 2.7 times higher risk of developing cardiovascular disease later.
  • Gestational diabetes (the emergence of type 2 diabetes during pregnancy) increases a woman’s risk of cardiovascular disease by 68% and increases a woman’s risk of type 2 diabetes after pregnancy by 10 times.
  • It has been found that premature birth (birth before 37 weeks) doubles a woman’s risk of developing cardiovascular disease and is strongly linked to later heart disease, stroke, and cardiovascular disease.
  • A disruption of the placenta (separation of the placenta from the uterus before birth) is associated with an 82% increased risk of cardiovascular disease.
  • Stillbirths (death of a baby before delivery) are associated with about twice the risk of CVD.

More studies examining the relationship between pregnancy complications and cardiovascular risk in Black, Hispanic, and Asian women are needed. Women in these racial / ethnic groups have less favorable pregnancy outcomes and a higher exposure to risk factors for cardiovascular disease and cardiovascular disease than white women. The explanatory group suggests that aggressive risk factor modification is especially important in preventing cardiovascular disease in women in these racial / ethnic groups who have had adverse pregnancy outcomes.

Eating a healthy diet improves cardiovascular health in all women, and studies suggest that eating healthily in the three years leading up to pregnancy is associated with a lower risk of pregnancy complications. “A heart-healthy diet, sleep patterns, and increased physical activity in women with poor pregnancy outcomes should begin during pregnancy and continue postpartum and for the remainder of the patient’s life. These are important lifestyle measures to reduce the risk of CVD. “said Parikh.

The statement also notes that breastfeeding can lower a woman’s risk of developing CVD and metabolic disorders, including type 2 diabetes, later on. The writing group also suggests ways to improve the transition of care after pregnancy:

  • Extended postpartum follow-up, sometimes called the “fourth trimester,” to look for CVD risk factors and provide CVD prevention advice.
  • Improve the transfer of health information between obstetricians and general practitioners to remove inconsistencies in electronic health record documentation to improve patient care.
  • A short and specific medical history for each woman to confirm whether she has any of the six risk factors during pregnancy: high blood pressure in pregnancy, gestational diabetes, premature birth, pregnancy, loss of pregnancy, or abortion.

“If a woman has had any of these adverse pregnancy outcomes, consider close blood pressure monitoring, type 2 diabetes and lipid screening, and more aggressive risk factor modifications and CVD prevention recommendations,” Parikh said. “Our data support the previous AHA recommendation that these important adverse pregnancy outcomes should be” risk enhancers “to guide consideration for statin therapy for CVD prevention in women.”

The statement also suggests considering preventive medications as appropriate for certain patients. However, more research is needed to better understand the effects of drugs used to prevent cardiovascular disease in women following poor pregnancy outcomes.

In an accompanying editorial, Dr. med. Eliza C. Miller, Assistant Professor of Neurology at Columbia University, suggested that pregnancy and the postpartum period are a critical window of time in a woman’s life for identifying cardiovascular disease risk and improving a woman’s health. “Pregnancy and the postpartum period should be viewed as the ‘golden year’ of opportunity for clinicians to identify young women at risk and work with them to improve their future for cardiovascular health,” Miller said.

The study identifies cardiovascular risk factors that can lead to pregnancy problems in first-time mothers

More information:
Edition (2021). DOI: 10.1161 / CIR.0000000000000961 Provided by the American Heart Association

Quote: Six pregnancy complications are among the red flags for heart disease later in life (2021, March 29), released on March 29, 2021 from heart.html

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