Pre-eclampsia and Long-Term Cardiovascular Disease Consequences
Article Sidebar
Main Article Content
Abstract
Pre-eclampsia (PE) is a hypertensive disorder of pregnancy that leads to multisystem maternal endothelial dysfunction. PE affects 3–5% of all pregnancies and is responsible for over 70,000 maternal deaths and 500,000 fetal deaths worldwide every year. The incidence of pre-eclampsia continues to increase worldwide year on year, while due to increased recognition and early intervention, the rates of maternal death from PE are falling.[1] Large strides have also been made in the understanding of pre-eclampsia in recent years through pre-clinical and clinical research. However, our understanding of the pathophysiology and the heterogeneity of PE remains incomplete. PE is now recognized as a disorder beyond pregnancy with long-term consequences with an increased risk of future cardiovascular disease which is now well documented in this cohort. As the incidence of PE increases, this will place an ever-growing burden on health-care systems worldwide. PE must, therefore, be recognized as requiring continued care outside of pregnancy and structures and systems must be put in place worldwide to enable this.
Metrics
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
All open access articles published in the journal are distributed under the terms of the CC-BY-NC-SA 4.0 license (Creative Commons Attribution-Non-commercial 4.0 International License) which permits unrestricted use, distribution, and reproduction in any medium, for non-commercial purposes, provided the original work is properly cited. Under Creative Commons, authors retain copyright in their articles.
References
Wang W, Xie X, Yuan T, Wang Y, Zhao F, Zhou Z, et al. Epidemiological trends of maternal hypertensive disorders of pregnancy at the global, regional, and national levels: A population‐based study. BMC Pregnancy Childbirth 2021;21:364.
Poon LC, Shennan A, Hyett JA, Kapur A, Hadar E, Divakar H, et al. The international federation of gynecology and obstetrics (FIGO) initiative on pre‐eclampsia: A pragmatic guide for first‐trimester screening and prevention. Int J Gynecol Obstet 2019;145 Suppl 1:1-33.
Hogan MC, Foreman KJ, Naghavi M, Ahn SY, Wang M, Makela SM, et al. Maternal mortality for 181 countries, 1980- 2008: A systematic analysis of progress towards millennium development goal 5. Lancet 2010;375:1609-23.
Brown MA, Magee LA, Kenny LC, Karumanchi SA, McCarthy FP, Saito S, et al. The hypertensive disorders of pregnancy: ISSHP classification, diagnosis management recommendations for international practice. Hypertension 2018;72:24-43.
Bell MJ. A historical overview of preeclampsia‐eclampsia. J Obstet Gynecol Neonatal Nurs 2010;39:510-8.
Germain AM, Romanik MC, Guerra I, Solari S, Reyes MS, Johnson RJ, et al. Endothelial dysfunction. Hypertension 2007;49:170-7.
Roberts JM, Rich-Edwards JW, McElrath TF, Garmire L, Myatt L. Subtypes of preeclampsia: Recognition and determining clinical usefulness. Hypertension 2021;77:1430-41.
Rana S, Lemoine E, Granger JP, Karumanchi SA. Preeclampsia. Circ Res 2019;124:1094-112.
Myatt L, Miodovnik M. Prediction of preeclampsia. Semin Perinatol 1999;23:45-57.
Redman CW, Staff AC. Preeclampsia, biomarkers, syncytiotrophoblast stress, and placental capacity. Am J Obstet Gynecol 2015;213:S9.e1-4.
Xiong X, Fraser WD. Impact of pregnancy-induced hypertension on birthweight by gestational age. Paediatr Perinatal Epidemiol 2004;18:186-91.
Sibai BM. Etiology and management of postpartum hypertensionpreeclampsia. Am J Obstet Gynecol 2012;206:470-5.
Redman EK, Hauspurg A, Hubel CA, Roberts JM, Jeyabalan A. Clinical course, associated factors, and blood pressure profile of delayed-onset postpartum preeclampsia. Obstet Gynecol 2019;134:995-1001.
Khosla K, Heimberger S, Nieman KM, Tung A, Shahul S, Staff AC, et al. Long-term cardiovascular disease risk in women after hypertensive disorders of pregnancy: Recent advances in hypertension. Hypertension 2021;78:927-35.
Anon. The National Institute for Health and Care Excellence (NICE) 2019. Hypertension in Adults: Diagnosis and Management. Nice Guideline, No. 136; 2019. Available from: https://www.nice.org.uk/guidance/ng136 [Last accessed on 2021 Mar 16].
Wu P, Haththotuwa R, Kwok CS, Babu A, Kotronias RA, Rushton C, et al. Preeclampsia and future cardiovascular health. Circulation 2017;10:e003497.
Chourdakis E, Oikonomou N, Fouzas S, Hahalis G, Karatza AA. Preeclampsia emerging as a risk factor of cardiovascular disease in women. High Blood Pressure Cardiovasc Prev 2021;28:103-14.
Foo FL, Mahendru AA, Masini G, Fraser A, Cacciatore S, MacIntyre DA, et al. Association between prepregnancy cardiovascular function and subsequent preeclampsia or fetal growth restriction. Hypertension 2018;72:442-50.
Leon LJ, McCarthy FP, Direk K, Gonzalez-Izquierdo A, PrietoMerino D, Casas JP, et al. Preeclampsia and cardiovascular disease in a large UK pregnancy cohort of linked electronic health records. Circulation 2019;140:1050-60.
National Institute for Health and Care Excellence. Hypertension in Pregnancy: Diagnosis and Management NICE Guideline No. 133; 2019.
Irgens HU, Reisater L, Irgens LM, Lie RT, Roberts JM. Long term mortality of mothers and fathers after pre-eclampsia: Population based cohort study Pre-eclampsia and cardiovascular disease later in life: Who is at risk? BMJ 2001;323:1213-7.
Grandi SM, Filion KB, Yoon S, Ayele HT, Doyle CM, Hutcheon JA, et al. Cardiovascular disease-related morbidity and mortality in women with a history of pregnancy complications. Circulation 2019;139:1069-79.
Cirillo PM, Cohn BA. Pregnancy complications and cardiovascular disease death. Circulation 2015;132:1234-42.
Bellamy L, Casas JP, Hingorani AD, Williams DJ. Pre-eclampsia and risk of cardiovascular disease and cancer in later life: Systematic review and meta-analysis. BMJ 2007;335:974.
Ray JG, Vermeulen MJ, Schull MJ, Redelmeier DA. Cardiovascular health after maternal placental syndromes (CHAMPS): Population-based retrospective cohort study. Lancet 2005;366:1797-803.
Mosca L, Benjamin EJ, Berra K, Bezanson JL, Dolor RJ, Lloyd-Jones DM, et al. Effectiveness-based guidelines for the prevention of cardiovascular disease in women 2011 update. Circulation 2011;123:1243-62.
Regitz-Zagrosek V, Roos-Hesselink JW, Bauersachs J, Blomström-Lundqvist C, Cífková R, de Bonis M, et al. 2018 ESC Guidelines for the management of cardiovascular diseasesduring pregnancy. Eur Heart J 2018;39:3165-241.
Bushnell C, McCullough LD, Awad IA, Chireau MV, Fedder WN, Furie KL, et al. Guidelines for the prevention of stroke in women. Stroke 2014;45:1545-88.
Anon. Hypertension in pregnancy. Obstet Gynecol 2013;122:1122-31.
Anon. ACOG Committee Opinion No. 736: Optimizing Postpartum Care. Obstet Gynecol 2018;131:e140-50.