Long-Term Cardiovascular Risks Associated With Adverse Pregnancy Outcomes: JACC Review Topic of the Week

Abbi D. Lane-Cordova, Sadiya S. Khan, William A. Grobman, Philip Greenland, Sanjiv J. Shah*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

47 Scopus citations

Abstract

Adverse pregnancy outcomes (APOs)—including pre-term birth, pre-eclampsia, and intrauterine growth restriction—are common interrelated disorders caused by placental dysfunction and maternal vascular abnormalities (endothelial activation, inflammation, and vasospasm) that occur in approximately 10% to 20% of pregnancies. Women who experience APOs are at increased risk for future cardiovascular disease (CVD). APOs are associated with increased risk of development of hypertension, left ventricular hypertrophy/dysfunction, vascular dysfunction, and renal dysfunction. The vascular abnormalities that are present during an APO also underlie common, difficult-to-treat forms of CVD in women as they age (e.g., cardiac microvascular dysfunction, heart failure with preserved ejection fraction), suggesting shared mechanistic pathways for APOs and CVD. Here, the authors synthesize the current information and knowledge gaps regarding the progression from APO to CVD. Understanding the risk factors for and pathogenesis of APO-related cardiovascular dysfunction is a critical unmet need that could inform efforts to prevent and more effectively treat CVD in women.

Original languageEnglish (US)
Pages (from-to)2106-2116
Number of pages11
JournalJournal of the American College of Cardiology
Volume73
Issue number16
DOIs
StatePublished - Apr 30 2019

Keywords

  • myocardial dysfunction
  • placenta
  • pre-eclampsia
  • pregnancy
  • vascular dysfunction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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