The Association of Adverse Pregnancy Outcomes and Cardiovascular Disease: Current Knowledge and Future Directions

2020 ◽  
Vol 22 (12) ◽  
Author(s):  
Anum S. Minhas ◽  
Wendy Ying ◽  
S. Michelle Ogunwole ◽  
Michael Miller ◽  
Sammy Zakaria ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Pregnancy Outcomes ◽  
Current Knowledge ◽  
Adverse Pregnancy Outcomes ◽  
Future Directions ◽  
Adverse Pregnancy

Adverse Pregnancy Outcomes Are Associated With Coronary Artery and Cardiovascular Disease Risk

2006 ◽  
Vol 107 (Supplement) ◽  
pp. 27S
Author(s):  
Monique V. Chireau ◽  
Mimi Biswas ◽  
Emily Honeycutt ◽  
Haywood Brown ◽  
L Kristin Newby ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery ◽  
Pregnancy Outcomes ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Pregnancy

Do adverse pregnancy outcomes contribute to accelerated cardiovascular events seen in young women with systemic lupus erythematosus?

Lupus ◽  
2017 ◽  
Vol 26 (13) ◽  
pp. 1351-1367 ◽  
Author(s):  
M C Soh ◽  
C Nelson-Piercy ◽  
M Westgren ◽  
L McCowan ◽  
D Pasupathy
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Cardiovascular Disease ◽  
Young Women ◽  
Lupus Erythematosus ◽  
Pregnancy Outcomes ◽  
Cardiovascular Events ◽  
Adverse Pregnancy Outcomes ◽  
Systemic Lupus ◽  
Adverse Pregnancy

Cardiovascular events (CVEs) are prevalent in patients with systemic lupus erythematosus (SLE), and it is the young women who are disproportionately at risk. The risk factors for accelerated cardiovascular disease remain unclear, with multiple studies producing conflicting results. In this paper, we aim to address both traditional and SLE-specific risk factors postulated to drive the accelerated vascular disease in this cohort. We also discuss the more recent hypothesis that adverse pregnancy outcomes in the form of maternal–placental syndrome and resultant preterm delivery could potentially contribute to the CVEs seen in young women with SLE who have fewer traditional cardiovascular risk factors. The pathophysiology of how placental-mediated vascular insufficiency and hypoxia (with the secretion of placenta-like growth factor (PlGF) and soluble fms-tyrosine-like kinase-1 (sFlt-1), soluble endoglin (sEng) and other placental factors) work synergistically to damage the vascular endothelium is discussed. Adverse pregnancy outcomes ultimately are a small contributing factor to the complex pathophysiological process of cardiovascular disease in patients with SLE. Future collaborative studies between cardiologists, obstetricians, obstetric physicians and rheumatologists may pave the way for a better understanding of a likely multifactorial aetiological process.

Impact of heart disease on maternal, fetal and neonatal outcomes in a low-resource setting

Heart ◽  
2018 ◽  
Vol 105 (10) ◽  
pp. 755-760 ◽  
Author(s):  
Andrea Beaton ◽  
Emmy Okello ◽  
Amy Scheel ◽  
Alyssa DeWyer ◽  
Renny Ssembatya ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Pregnancy Outcomes ◽  
Attributable Risk ◽  
Case Finding ◽  
Adverse Pregnancy Outcomes ◽  
Active Case Finding ◽  
Adverse Pregnancy ◽  
Rheumatic Heart

BackgroundThe burden of pre-existing cardiovascular disease and the contribution to adverse pregnancy outcomes are not robustly quantified, particularly in low-income countries. We aimed to determine both the prevalence of maternal heart disease through active case finding and its attributable risk to adverse pregnancy outcomes.MethodsWe conducted a 24-month prospective longitudinal investigation in three Ugandan health centres, using echocardiography for active case finding during antenatal care. Women with and without heart disease were followed to 6 weeks post partum to determine pregnancy outcomes. Prevalence of heart disease was calculated. Per cent attributable risk estimates were generated for maternal, fetal and neonatal mortality.ResultsScreening echocardiography was performed in 3506 women. The prevalence of heart disease was 17 per 1000 women (95% CI 13 to 21); 15 per 1000 was rheumatic heart disease. Only 3.4% of women (2/58) had prior diagnosis. Cardiovascular complications occurred in 51% of women with heart disease, most commonly heart failure. Per cent attributable risk of heart disease on maternal mortality was 88.6% in the exposed population and 10.8% in the overall population. Population attributable risk of heart disease on fetal death was 1.1% and 6.0% for neonatal mortalityConclusionsOccult maternal heart disease may be responsible for a substantial proportion of adverse pregnancy outcomes in low-resource settings. Rheumatic heart disease is, by far, the most common condition, urging global prioritisation of this neglected cardiovascular disease.

scholarly journals Placental Ageing in Adverse Pregnancy Outcomes: Telomere Shortening, Cell Senescence, and Mitochondrial Dysfunction

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Samprikta Manna ◽  
Cathal McCarthy ◽  
Fergus P. McCarthy
Keyword(s):  
Oxidative Stress ◽  
Mitochondrial Dysfunction ◽  
Pregnancy Outcomes ◽  
Current Knowledge ◽  
Neonatal Morbidity ◽  
Adverse Pregnancy Outcomes ◽  
Premature Ageing ◽  
Dna Mutations ◽  
Critical Organ ◽  
Adverse Pregnancy

Preeclampsia is a multisystemic pregnancy disorder and a major cause of maternal and neonatal morbidity and mortality worldwide. The exact pathophysiology of preeclampsia remains unclear; however, it is speculated that the various pathologies can be attributed to impaired vascular remodelling and elevated oxidative stress within the placenta. Oxidative stress plays a key role in cell ageing, and the persistent presence of elevated oxidative stress precipitates cellular senescence and mitochondrial dysfunction, resulting in premature ageing of the placenta. Premature ageing of the placenta is associated with placental insufficiency, which reduces the functional capacity of this critical organ and leads to abnormal pregnancy outcomes. The changes brought about by oxidative insults are irreversible and often lead to deleterious modifications in macromolecules such as lipids and proteins, DNA mutations, and alteration of mitochondrial functioning and dynamics. In this review, we have summarized the current knowledge of placental ageing in the aetiology of adverse pregnancy outcomes and discussed the hallmarks of ageing which could be potential markers for preeclampsia and fetal growth restriction.

scholarly journals Pregnancy-Related Extracellular Vesicles Revisited

2021 ◽  
Vol 22 (8) ◽  
pp. 3904
Author(s):  
Carmen Elena Condrat ◽  
Valentin Nicolae Varlas ◽  
Florentina Duică ◽  
Panagiotis Antoniadis ◽  
Cezara Alina Danila ◽  
...  
Keyword(s):  
Extracellular Vesicles ◽  
Pregnancy Outcomes ◽  
Messenger Rna ◽  
Viral Infections ◽  
Current Knowledge ◽  
First Trimester ◽  
Maternal Blood ◽  
Adverse Pregnancy Outcomes ◽  
Liquid Biopsies ◽  
Adverse Pregnancy

Extracellular vesicles (EVs) are small vesicles ranging from 20–200 nm to 10 μm in diameter that are discharged and taken in by many different types of cells. Depending on the nature and quantity of their content—which generally includes proteins, lipids as well as microRNAs (miRNAs), messenger-RNA (mRNA), and DNA—these particles can bring about functional modifications in the receiving cells. During pregnancy, placenta and/or fetal-derived EVs have recently been isolated, eliciting interest in discovering their clinical significance. To date, various studies have associated variations in the circulating levels of maternal and fetal EVs and their contents, with complications including gestational diabetes and preeclampsia, ultimately leading to adverse pregnancy outcomes. Furthermore, EVs have also been identified as messengers and important players in viral infections during pregnancy, as well as in various congenital malformations. Their presence can be detected in the maternal blood from the first trimester and their level increases towards term, thus acting as liquid biopsies that give invaluable insight into the status of the feto-placental unit. However, their exact roles in the metabolic and vascular adaptations associated with physiological and pathological pregnancy is still under investigation. Analyzing peer-reviewed journal articles available in online databases, the purpose of this review is to synthesize current knowledge regarding the utility of quantification of pregnancy related EVs in general and placental EVs in particular as non-invasive evidence of placental dysfunction and adverse pregnancy outcomes, and to develop the current understanding of these particles and their applicability in clinical practice.

Interventions to Mitigate Risk of Cardiovascular Disease After Adverse Pregnancy Outcomes

2021 ◽  
Author(s):  
Amanda R. Jowell ◽  
Amy A. Sarma ◽  
Martha Gulati ◽  
Erin D. Michos ◽  
Arthur J. Vaught ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Pregnancy
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