Department of Obstetrics and Gynecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
Department of Obstetrics and Gynecology, Kingston Health Sciences Centre, Queen's University, Kingston, Ontario, Canada.
Int J Gynaecol Obstet. 2023 Jan;160 Suppl 1:22-34. doi: 10.1002/ijgo.14540.
Hypertensive disorders of pregnancy (HDP) are the most common causes of maternal and perinatal morbidity and mortality. They are responsible for 16% of maternal deaths in high-income countries and approximately 25% in low- and middle-income countries. The impact of HDP can be lifelong as they are a recognized risk factor for future cardiovascular disease. During pregnancy, the cardiovascular system undergoes significant adaptive changes that ensure adequate uteroplacental blood flow and exchange of oxygen and nutrients to nurture and accommodate the developing fetus. Failure to achieve normal cardiovascular adaptation is associated with the development of HDP. Hemodynamic alterations in women with a history of HDP can persist for years and predispose to long-term cardiovascular morbidity and mortality. Therefore, pregnancy and the postpartum period are an opportunity to identify women with underlying, often unrecognized, cardiovascular risk factors. It is important to develop strategies with lifestyle and therapeutic interventions to reduce the risk of future cardiovascular disease in those who have a history of HDP.
妊娠高血压疾病（HDP）是孕产妇和围产儿发病率和死亡率的最常见原因。在高收入国家，HDP 导致 16%的孕产妇死亡，在中低收入国家则约占 25%。HDP 的影响可能是终身的，因为它们是未来心血管疾病的公认危险因素。在怀孕期间，心血管系统会发生显著的适应性变化，以确保充足的胎盘血流和氧气及营养物质的交换，从而滋养和适应发育中的胎儿。未能实现正常的心血管适应与 HDP 的发展有关。有 HDP 病史的女性的血液动力学改变可能会持续多年，并导致长期心血管发病率和死亡率增加。因此，妊娠和产后是识别有潜在心血管危险因素的女性的机会。重要的是制定生活方式和治疗干预策略，以降低有 HDP 病史的女性未来发生心血管疾病的风险。
