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Markers of Cardiovascular Risk Associated with Pregnancy

  • Women and Cardiovascular Health (N Goldberg and S Lewis, Section Editors)
  • Published:
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Abstract

Purpose of Review

The purpose of the review is to summarize the unique cardiovascular disease (CVD) risk factors encountered during pregnancy and to provide the reader with a framework for acquiring a comprehensive obstetric history during the cardiovascular (CV) assessment of women.

Recent Findings

Individuals with a history of pregnancies complicated by hypertensive disorders of pregnancy (HDP), gestational diabetes (GDM), preterm delivery, low birth weight, and fetal growth restriction during pregnancy are at a higher risk of develo** short- and long-term CV complications compared to those without adverse pregnancy outcomes (APOs). Women with a history of APOs can be at increased risk of CVD even after achieving normoglycemia and normal blood pressure control postpartum. Risk assessment and stratification in women must account for these APOs as recommended by the 2019 American College of Cardiology (ACC)/American Heart Association (AHA) guideline on the primary prevention of CVD. Early recognition, monitoring, and treatment of APOs are key to limiting CVD complications late in maternal life.

Summary

Recognition of APOs as female-specific cardiovascular risk factors is critical for risk stratification for women and birthing persons. Further research is needed to understand the complex interplay between genetics, environmental, behavioral, and maternal vascular health, and the association between APOs and CVD risk.

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Authors and Affiliations

  1. Women’s Heart Center, The Christ Hospital Heart and Vascular Institute, Cincinnati, OH, USA

    Odayme Quesada

  2. The Carl and Edyth Lindner Center for Research and Education, The Christ Hospital, Cincinnati, OH, USA

    Odayme Quesada

  3. Department of Cardiovascular Services, The Queen Elizabeth Hospital, Bridgetown, Barbados

    Dawn C. Scantlebury

  4. Faculty of Medical Sciences, The University of the West Indies, Cave Hill, St. Michael, Barbados

    Dawn C. Scantlebury

  5. Division of Cardiology, University of Illinois Chicago, Chicago, IL, USA

    Joan E. Briller

  6. Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Erin D. Michos

  7. Department of Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Niti R. Aggarwal

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  1. Odayme Quesada
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  3. Joan E. Briller
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Correspondence to Niti R. Aggarwal.

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Conflict of Interest

Dr. Quesada is supported by the NIH K23-HL151867. Dr. Michos is supported by the Amato Fund in Women’s Cardiovascular Health at Johns Hopkins University. Dr. Michos reports Advisory Boards with Amarin, AstraZenca, Bayer, Boehringer Ingelheim, Esperion, Novartis, Novo Nordisk, and Pfizer. Dr. Briller is an unpaid consultant for the Illinois Maternal Mortality Committee and is on the Steering committee for the REBIRTH trial of bromocriptine in Peripartum Cardiomyopathy (NCT05180773).

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Quesada, O., Scantlebury, D.C., Briller, J.E. et al. Markers of Cardiovascular Risk Associated with Pregnancy. Curr Cardiol Rep 25, 77–87 (2023). https://doi.org/10.1007/s11886-022-01830-1

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