AI Insight
This Lancet series article examines how adverse pregnancy outcomes (APOs) serve as indicators of future cardiovascular disease risk in women. Common pregnancy complications such as hypertensive disorders, gestational diabetes, and preterm birth are associated with substantially elevated long-term cardiovascular morbidity and mortality compared to uncomplicated pregnancies. These risks appear to result from a combination of pre-existing genetic and cardiometabolic vulnerabilities that are unmasked by pregnancy's physiological stress, leading to accelerated disease trajectories and impaired vascular function.
Why it matters
This research highlights the importance of pregnancy history in assessing women's long-term cardiovascular risk, potentially enabling earlier identification and preventive interventions for at-risk populations. Recognizing pregnancy complications as cardiovascular risk markers could improve lifetime health monitoring and reduce cardiovascular disease burden in women who experienced APOs.
Understand the Science
Pregnancy provides a unique physiological stress test for the cardiovascular system, during which, adverse pregnancy outcomes (APOs) can unmask latent susceptibility to future disease. Common complications, including hypertensive disorders of pregnancy (HDP), gestational diabetes, and preterm birth (delivery before 37 weeks’ gestation), identify women at substantially higher long-term risk of cardiovascular morbidity and mortality compared with women without a history of APOs. These excess risks likely reflect the combined effects of pre-existing cardiometabolic and genetic susceptibility, as well as the haemodynamic and metabolic stressors of pregnancy, heralding accelerated risk factor trajectories, relative impairment in endothelial and microvascular function, and early disease onset.
Source: [Series] Adverse pregnancy outcomes and long-term cardiovascular disease risk