Top Things to Know: Adverse Pregnancy Outcomes and CVD Risk
Published: March 29, 2021
- This statement reviews and summarizes published evidence that APOs (hypertensive disorders of pregnancy, preterm delivery, gestational diabetes, small for gestational age delivery, and pregnancy loss) increase a woman’s risk of developing cardiovascular disease (CVD) risk factor development, and of developing later CVD.
- APOs (hypertensive disorders of pregnancy, preterm delivery, gestational diabetes, small for gestational age delivery, and pregnancy loss) increase a woman’s probability of CVD risk factor development, and of developing CVD later in life.
- APO’s should be considered when evaluating CVD risk in women, even though their value in reclassifying risk has not yet been established.
- A history of APO’s should prompt more vigorous primordial prevention of CVD risk factors and primary prevention of CVD.
- Adopting a heart healthy diet, healthy sleep patterns and increasing physical activity among women with adverse pregnancy outcomes, starting in the post-partum setting and continuing across the lifespan, are important lifestyle interventions to decrease CVD risk.
- Lactation/ breastfeeding may lower a woman’s later-life cardiometabolic risk.
- Black and Asian women experience a higher proportion APOs, with more severe clinical presentation and worse outcomes, than white women.
- More studies examining the association of APOs and CVD in non-white populations of women need to be performed to better address these health disparities.
- Future studies of aspirin, statins and metformin may better inform our recommendations for pharmacotherapy in primary CVD prevention among women who have had an APOs.
- Healthcare systems need to improve transitions of care for women with adverse pregnancy outcomes and implement strategies to reduce their long-term CVD risk.
Citation
Parikh NI, Gonzalez JM, Anderson CAM, Judd SE, Rexrode KM, Hlatky MA, Gunderson EP, Stuart JJ, Vaidya D; on behalf of the American Heart Association Council on Epidemiology and Prevention; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular and Stroke Nursing; and the Stroke Council. Adverse pregnancy outcomes and cardiovascular disease risk: unique opportunities for cardiovascular disease prevention in women: a scientific statement from the American Heart Association [published online ahead of print March 29, 2021]. Circulation. doi: 10.1161/CIR.0000000000000961