妊娠相关心血管风险指标:产后管理和预防未来疾病的初级保健方法。

Pregnancy-related cardiovascular risk indicators: Primary care approach to postpartum management and prevention of future disease.

机构信息

Family medicine resident at Queen's University in Kingston, Ont.

Family physician and Assistant Professor in the Department of Family Medicine at Queen's University.

出版信息

Can Fam Physician. 2019 Dec;65(12):883-889.

DOI:
Abstract

OBJECTIVE

To define pregnancy-related cardiovascular risk indicators and their association with developing future cardiovascular disease (CVD), and to provide guidance on how primary care providers can help lower future CVD risk through early identification and intervention.

SOURCES OF INFORMATION

Primary research sources, systematic reviews and meta-analyses, and clinical review articles.

MAIN MESSAGE

Cardiovascular disease is the leading cause of death in women. As underlying CVD risk factors are often present for years before the onset of CVD, it is important to use innovative ways to identify women who should undergo CVD risk screening at a younger age. Pregnancy and the postpartum period afford that opportunity, given that the development of certain pregnancy complications (hypertensive disorders of pregnancy, gestational diabetes mellitus, idiopathic preterm birth, delivery of a baby with intrauterine growth restriction, or placental abruption) can reliably identify women with underlying, often unrecognized, CVD risk factors.

CONCLUSION

Women with 1 or more of these pregnancy complications should be identified at the time of delivery and have formalized postpartum follow-up, including a thorough history, a physical examination, biochemical screening, counseling around lifestyle modification, and possible therapeutic intervention. The link between pregnancy complications and future CVD affords the earliest opportunity for CVD risk assessment for health preservation and disease prevention.

摘要

目的

定义与未来发生心血管疾病(CVD)相关的妊娠相关心血管风险指标,并提供指导,说明初级保健提供者如何通过早期识别和干预来降低未来 CVD 风险。

信息来源

主要研究来源、系统评价和荟萃分析以及临床综述文章。

主要信息

心血管疾病是女性死亡的主要原因。由于潜在的 CVD 危险因素在 CVD 发作前通常存在多年,因此重要的是要采用创新方法来识别应该在更年轻时进行 CVD 风险筛查的女性。妊娠和产后期间提供了这样的机会,因为某些妊娠并发症(妊娠高血压疾病、妊娠期糖尿病、特发性早产、宫内生长受限婴儿的分娩或胎盘早剥)的发展可以可靠地识别出存在潜在、通常未被识别的 CVD 危险因素的女性。

结论

在分娩时应识别出具有 1 种或多种这些妊娠并发症的女性,并进行规范化的产后随访,包括详细的病史、体格检查、生化筛查、围绕生活方式改变的咨询以及可能的治疗干预。妊娠并发症与未来 CVD 之间的联系为进行 CVD 风险评估以保持健康和预防疾病提供了最早的机会。

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