Opportunities in the Postpartum Period to Reduce Cardiovascular Disease Risk after Adverse Pregnancy Outcomes: A Scientific Statement from the American Heart Association

Jennifer Lewey, Theresa M. Beckie, Haywood L. Brown, Susan D. Brown, Vesna D. Garovic, Sadiya S. Khan, Eliza C. Miller, Garima Sharma, Laxmi S. Mehta

Research output: Contribution to journalReview articlepeer-review

19 Scopus citations

Abstract

Adverse pregnancy outcomes are common among pregnant individuals and are associated with long-term risk of cardiovascular disease. Individuals with adverse pregnancy outcomes also have an increased incidence of cardiovascular disease risk factors after delivery. Despite this, evidence-based approaches to managing these patients after pregnancy to reduce cardiovascular disease risk are lacking. In this scientific statement, we review the current evidence on interpregnancy and postpartum preventive strategies, blood pressure management, and lifestyle interventions for optimizing cardiovascular disease using the American Heart Association Life's Essential 8 framework. Clinical, health system, and community-level interventions can be used to engage postpartum individuals and to reach populations who experience the highest burden of adverse pregnancy outcomes and cardiovascular disease. Future trials are needed to improve screening of subclinical cardiovascular disease in individuals with a history of adverse pregnancy outcomes, before the onset of symptomatic disease. Interventions in the fourth trimester, defined as the 12 weeks after delivery, have great potential to improve cardiovascular health across the life course.

Original languageEnglish (US)
Pages (from-to)E330-E346
JournalCirculation
Volume149
Issue number7
DOIs
StatePublished - Feb 13 2024

Keywords

  • AHA Scientific Statements
  • cardiovascular diseases
  • diabetes, gestational
  • postpartum period
  • pregnancy
  • pregnancy complications
  • primary prevention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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