Adverse Pregnancy Outcomes and Cardiovascular Disease Risk in Women with Nisha Parikh, MD

Article

The American Heart Association is highlighting the effect of adverse pregnancy outcomes on risk of cardiovascular disease later in life among women. Check out this interview with the chair of the writing committee for more perspective on the statement.

Focused on the improvement of cardiovascular health in women, the American Heart Association’s latest scientific statement highlights 6 pregnancy complications that signal increased risk of cardiovascular disease later in life.

The statement, which was published in Circulation, not only details the impact of adverse pregnancy outcomes, but also provides perspective on the influence lifestyle modification and race/ethnic background can have on cardiovascular disease risk among women who experience these adverse pregnancy outcomes.

Adverse Pregnancy Outcomes and CVD

Adverse Pregnancy Outcome
Outcome association
Level of Evidence
HDP
ASCVD
A
Gestational Diabetes
ASCVD
A
Preterm Delivery
ASCVD
A
Small for Gestational Age
ASCVD
A
Large for Gestational Age
ASCVD
B
Placental Abruption
ASCVD
A
Miscarriage/Stillbirth
ASCVD
A

*Strength of Evidence "A" indicates multiple consistent cohort studies, meta-analyses, or both.
**Information obtained from AHA statement.

“Preventing or treating risk factors early can prevent cardiovascular disease, therefore, adverse pregnancy outcomes can be a powerful window into cardiovascular disease prevention if women and their health care professionals harness the knowledge and use it for health improvement,” said Nisha I. Parikh, MD, MPH, chair of the scientific statement writing committee and associate professor of medicine in the cardiovascular division at the University of California at San Francisco, in a statement.

With improving cardiovascular care and research among women a major goal of cardiologists and cardiology organizations in the US, the AHA released the statement with the aim of highlighting and recognizing the impact of adverse pregnancy outcomes when cardiovascular risk is assessed among women. Among the 6 specific red flags included in the statement were hypertensive disorders of pregnancy, preeclampsia, gestational diabetes, preterm delivery, placental abruption, and stillbirth.

Each of these aforementioned factors received a subsection of the document where writing committee members provided insight into the risk increase and research used to support the statement. Additionally, investigators also provide a table detailing the risks of specific cardiovascular outcomes associated with each adverse pregnancy outcome listed.

Also included in the scientific statement is a chart detailing an ideal cardiovascular screening timeline for pregnant women. This chart recommends postpartum assessments of cardiovascular disease risk factors and lifestyle counseling at 6 weeks, 8-12 weeks, 6 months, and 1 year. However, the chart suggests an Ob-Gyn should conduct the first 2 assessments and then recommends a care handoff to primary care providers after week 12.

For more on the statement and how to improve cardiovascular health of women, Practical Cardiology reached out Parikh for further insight into the AHA’s latest scientific statement.

This article, “Adverse Pregnancy Outcomes and Cardiovascular Disease Risk: Unique Opportunities for Cardiovascular Disease Prevention in Women,” was published in Circulation.

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