The Association of Adverse Pregnancy Outcomes and Cardiovascular Disease: Current Knowledge and Future Directions
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(2020) 22:61
Women’s Health (A Sarma, Section Editor)
The Association of Adverse Pregnancy Outcomes and Cardiovascular Disease: Current Knowledge and Future Directions Anum S. Minhas, MD1,2,3 Wendy Ying, MD1,2 S. Michelle Ogunwole, MD4 Michael Miller, MD5 Sammy Zakaria, MD, MPH2 Arthur J. Vaught, MD5 Allison G. Hays, MD2 Andreea A. Creanga, MD, PhD5,6 Ari Cedars, MD3,7 Erin D. Michos, MD, MHS1,2,3 Roger S. Blumenthal, MD1,2 Garima Sharma, MD1,2,* Address 1 Ciccarone Center for Prevention of Cardiovascular Disease, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA *,2 Division of Cardiology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA Email: [email protected] 3 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA 4 Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA 5 Division of Maternal Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA 6 Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA 7 Division of Pediatric Cardiology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA * Springer Science+Business Media, LLC, part of Springer Nature 2020
Anum S. Minhas and Wendy Ying contributed equally to this work. This article is part of the Topical Collection on Women’s Health
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Curr Treat Options Cardio Med
(2020) 22:61
Keywords Adverse pregnancy outcomes I Preeclampsia I Gestational diabetes I Preterm delivery I Maternal cardiovascular disease I Aspirin
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 i
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