Significance of Obstetrical History with Future Cardiovascular Disease Risk

By: Bassily et al. (American Journal of Medicine, 2018)

When a female is pregnant, her body undergoes major changes in the cardiovascular system. These changes are important for fetal development. This review article hopes to study the effects of the complications that a mother's health can come across during pregnancy. Cardiovascular disease (CVD) is one of the leading causes of female mortality in pregnant women.

One possible cause of CVD in pregnancy is gestational diabetes (GD), which is an intolerance to glucose during pregnancy (insulin resistance). Studies have shown that patients who had developed gestational diabetes had an increased risk of developing CVD later on in life. GD also showed to have affects on the vascularity of the mothers. Previous studies reported that there was decreased endothelium-dependent vasodilatation when compared to women who did not report to have GD. Arterial stiffness was also seen in women with GD. GD has also been seen to contribute to post-partum diabetes, hypertension, hyperlipidemia, and insulin resistance.

Another condition seen in pregnancies is preeclampsia, which is characterized by proteinuria and hypertension. "It is the leading cause of maternal and perinatal morbidity." The mechanisms of preeclampsia is not well understood, but is seen to contribute to CVD in both mothers and offspring.

 Women who deliver a new born with a low birth weight (less than 2.5 kg) have a 7-11 times the risk to die from CVD compared to mothers who did not deliver a baby with a low birth weight. There is a link between maternal risk factors for coronary heart disease.

Preterm delivery is premature birth, which is when the newborn is less than 37 weeks old when delivered. Studies show that when this occurs, women have twice the risk of developing coronary heart disease. Preterm labor seems to be an inflammatory process that leads to leukocyte infiltration at the cervix and uterine tissues. The coronary heart disease has been linked to this inflammatory response.

Healthcare providers must consider the history of pregnancies to prevent any future development of CVD. Preventable measures such as prescribing a low dose of aspirin or calcium supplementation will help. History documentation is very important to provide the proper care int he future for the mother.

This article was actually published a few days ago and I thought it was interesting because it relates the idea of how pregnancy can alter the women's future health. We are studying females more in the lab so I think it is important to consider all the different ways that CVD can be developed.


-Tsetse Fly