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The Association of Adverse Pregnancy Outcomes and Cardiovascular Disease: Current Knowledge and Future Directions

  • Women’s Health (A Sarma, Section Editor)
  • Published:
Current Treatment Options in Cardiovascular Medicine Aims and scope Submit manuscript

Abstract

Purpose of review

Adverse pregnancy outcomes are associated with increased risk for future cardiovascular disease. The goal of this review is to share what is currently known about the increased risk and to identify areas for future research.

Recent findings

Severe studies have identified a strong association between adverse pregnancy outcomes and cardiovascular disease such as heart failure, valvular disease, ischemic heart disease, stroke, hypertension, and metabolic syndrome. The recognition of this increased risk is reflected in recent changes in prevention guidelines. The guidelines now recognize sex-specific risks such as preeclampsia and preterm delivery and recommend incorporating a pregnancy history to identify them earlier. However, no robust risk prediction tools incorporating these pregnancy risk factors have been developed and validated. While smaller clinical trials have been performed in reducing cardiovascular risk factors in the postpartum timeframe, there remains a paucity of large-scale randomized clinical trials that continue to show a risk reduction in these women.

Summary

While there is increasing recognition of the long-term cardiovascular risks associated with adverse pregnancy outcomes, there remains a need for interventional studies aimed at reducing this risk and for incorporation of pregnancy risk factors into traditional cardiovascular risk prediction tools.

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Author notes

  1. Anum S. Minhas and Wendy Ying contributed equally to this work.

Authors and Affiliations

  1. Ciccarone Center for Prevention of Cardiovascular Disease, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Anum S. Minhas MD, Wendy Ying MD, Erin D. Michos MD, MHS, Roger S. Blumenthal MD & Garima Sharma MD

  2. Division of Cardiology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA

    Anum S. Minhas MD, Wendy Ying MD, Sammy Zakaria MD, MPH, Allison G. Hays MD, Erin D. Michos MD, MHS, Roger S. Blumenthal MD & Garima Sharma MD

  3. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Anum S. Minhas MD, Ari Cedars MD & Erin D. Michos MD, MHS

  4. Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    S. Michelle Ogunwole MD

  5. Division of Maternal Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Michael Miller MD, Arthur J. Vaught MD & Andreea A. Creanga MD, PhD

  6. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Andreea A. Creanga MD, PhD

  7. Division of Pediatric Cardiology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Ari Cedars MD

Authors
  1. Anum S. Minhas MD
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  2. Wendy Ying MD
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  3. S. Michelle Ogunwole MD
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  4. Michael Miller MD
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  5. Sammy Zakaria MD, MPH
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  6. Arthur J. Vaught MD
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  7. Allison G. Hays MD
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  8. Andreea A. Creanga MD, PhD
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  9. Ari Cedars MD
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  10. Erin D. Michos MD, MHS
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  11. Roger S. Blumenthal MD
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  12. Garima Sharma MD
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Corresponding author

Correspondence to Garima Sharma MD.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

Conflict of interest

Anum S. Minhas, Wendy Ying, S. Michelle Ogunwole, Michael Miller, Sammy Zakaria, Arthur J. Vaught, Allison G. Hays, Andreea A. Creanga, Ari Cedars, Erin D. Michos, Roger S. Blumenthal, and Garima Sharma declare that they have no conflict of interest.

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Minhas, A.S., Ying, W., Ogunwole, S.M. et al. The Association of Adverse Pregnancy Outcomes and Cardiovascular Disease: Current Knowledge and Future Directions. Curr Treat Options Cardio Med 22, 61 (2020). https://doi.org/10.1007/s11936-020-00862-6

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