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心血管风险标志物与妊娠的关系。

Markers of Cardiovascular Risk Associated with Pregnancy.

机构信息

Women's Heart Center, The Christ Hospital Heart and Vascular Institute, Cincinnati, OH, USA.

The Carl and Edyth Lindner Center for Research and Education, The Christ Hospital, Cincinnati, OH, USA.

出版信息

Curr Cardiol Rep. 2023 Feb;25(2):77-87. doi: 10.1007/s11886-022-01830-1. Epub 2023 Feb 6.

Abstract

PURPOSE OF REVIEW

The purpose of the review is to summarize the unique cardiovascular disease (CVD) risk factors encountered during pregnancy and to provide the reader with a framework for acquiring a comprehensive obstetric history during the cardiovascular (CV) assessment of women.

RECENT FINDINGS

Individuals with a history of pregnancies complicated by hypertensive disorders of pregnancy (HDP), gestational diabetes (GDM), preterm delivery, low birth weight, and fetal growth restriction during pregnancy are at a higher risk of developing short- and long-term CV complications compared to those without adverse pregnancy outcomes (APOs). Women with a history of APOs can be at increased risk of CVD even after achieving normoglycemia and normal blood pressure control postpartum. Risk assessment and stratification in women must account for these APOs as recommended by the 2019 American College of Cardiology (ACC)/American Heart Association (AHA) guideline on the primary prevention of CVD. Early recognition, monitoring, and treatment of APOs are key to limiting CVD complications late in maternal life. Recognition of APOs as female-specific cardiovascular risk factors is critical for risk stratification for women and birthing persons. Further research is needed to understand the complex interplay between genetics, environmental, behavioral, and maternal vascular health, and the association between APOs and CVD risk.

摘要

目的综述

本文旨在总结妊娠期间特有的心血管疾病(CVD)危险因素,并为读者提供在女性心血管(CV)评估期间获取全面产科病史的框架。

最近的发现

与无不良妊娠结局(APO)的女性相比,有妊娠合并高血压疾病(HDP)、妊娠期糖尿病(GDM)、早产、低出生体重和胎儿生长受限病史的个体发生短期和长期 CV 并发症的风险更高。即使在产后达到正常血糖和正常血压控制后,有 APO 病史的女性也可能面临 CVD 风险增加。2019 年美国心脏病学会(ACC)/美国心脏协会(AHA)关于 CVD 一级预防的指南建议,对女性进行风险评估和分层时必须考虑这些 APO。早期识别、监测和治疗 APO 对于限制产妇后期 CVD 并发症至关重要。认识到 APO 是女性特有的心血管危险因素对于女性和分娩者的风险分层至关重要。需要进一步研究以了解遗传、环境、行为和产妇血管健康之间的复杂相互作用,以及 APO 与 CVD 风险之间的关联。

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Markers of Cardiovascular Risk Associated with Pregnancy.心血管风险标志物与妊娠的关系。
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