Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, United States of America.
Women's Heart Center, The Christ Hospital Heart and Vascular Institute, Cincinnati, OH, United States of America.
Maturitas. 2022 Nov;165:1-7. doi: 10.1016/j.maturitas.2022.06.012. Epub 2022 Jul 2.
A growing body of literature highlights the importance of recognizing adverse pregnancy outcomes (APOs) as cardiovascular risk factors when risk stratifying women for cardiovascular disease (CVD). We conducted a comprehensive review of the long term cardiovascular consequences associated with APOs including hypertensive disorders of pregnancy (HDP), preterm delivery, gestational diabetes (GDM), low birth weight and fetal growth restriction during pregnancy using electronic databases, PubMed and the Cochrane Library. Women with pregnancies complicated by HDP, preterm birth, and low birth weight are at higher risk of developing CVD than were women without APOs in the years following pregnancy. Among women with a history of multiple APOs, HDP and GDM are independent risk factors for atherosclerotic CVD. The pathophysiology leading to CVD is multifactorial, and includes both physiologic and environmental factors. APOs should be accounted for in a women's CVD risk assessment and stratification as recommended by prevention guidelines. Further research is needed to determine the underlying mechanisms that lead to the increased risk of CVD in women with APOs.
越来越多的文献强调，在对女性进行心血管疾病 (CVD) 的风险分层时，将不良妊娠结局 (APO) 视为心血管风险因素的重要性。我们使用电子数据库、PubMed 和 Cochrane Library 对与 APO 相关的长期心血管后果进行了全面综述，包括妊娠高血压疾病 (HDP)、早产、妊娠期糖尿病 (GDM)、低出生体重和胎儿生长受限。与没有 APO 的女性相比，患有 HDP、早产和低出生体重的女性在妊娠后发生 CVD 的风险更高。在有多次 APO 病史的女性中，HDP 和 GDM 是动脉粥样硬化性 CVD 的独立危险因素。导致 CVD 的病理生理学是多因素的，包括生理和环境因素。APO 应在女性 CVD 风险评估和分层中得到考虑，正如预防指南所建议的那样。需要进一步研究以确定导致 APO 女性 CVD 风险增加的潜在机制。
