scholarly journals INTERVENTIONS TO MITIGATE CARDIOVASCULAR DISEASE RISK AFTER ADVERSE PREGNANCY OUTCOMES: A REVIEW

2021 ◽  
Vol 7 ◽  
pp. 100266
Author(s):  
Amanda R. Jowell ◽  
Amy A. Sarma ◽  
Martha Gulati Erin D. Michos ◽  
Arthur J. Vaught ◽  
Pradeep Natarajan ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Pregnancy Outcomes ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Adverse Pregnancy Outcomes ◽  
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

Abstract MP71: Ten Year Predicted Cardiovascular Disease Risk in Young Women With Adverse Pregnancy Outcomes

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Janet M Catov ◽  
Becky McNeil ◽  
Philip Greenland ◽  
Noel Bairey Merz ◽  
Deborah Ehrenthal ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Young Women ◽  
Pregnancy Outcomes ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Adverse Pregnancy Outcomes ◽  
Reproductive Age ◽  
Risk Scores ◽  
Cvd Risk ◽  
Adverse Pregnancy

Introduction: Cardiovascular disease (CVD) is the leading cause of death among women. In stark contrast to mortality declines in other groups, CVD deaths to young women are increasing. CVD prediction in this group is imprecise, and how adverse pregnancy outcomes (APO) may unmask risk during the reproductive years is unknown. Hypothesis: Women with APO will have higher 10-year predicted CVD risk within 7 years following a first pregnancy compared to women with no APO. Study design: We enrolled 10,038 women at 8 sites in their first pregnancy and followed 4,500 through a CVD visit 2-7 years later. Presented here are results for the first 2,705 with lab results and no hypertension or diabetes before pregnancy. The Atherosclerotic CVD (ASCVD), American Health Association Healthy Heart, Pathobiological Determinants of Atherosclerosis in Youth (PDAY), and Reynolds risk scores were compared in women with preterm birth (PTB), preeclampsia/gestational hypertension (PE/GH), gestational diabetes (GDM), small for gestational age (SGA), and no adverse outcomes (no APO, referent). Results: As expected, 10-year predicted CVD risk was very low in women at a median age of 30, although differences at the tail of the distribution were detected based on APO history. Women with no APO had the lowest CVD risk. Women with PTB, PE/GH, GDM, or SGA had higher 10-year CVD risk as predicted by the ASCVD score compared to women with no APO (p<0.05 for PTB and PE/GH). Six to 10% of women with these APOs had ASCVD scores greater than 5%. The PDAY score that predicts risk of coronary artery calcification in young adults was also higher in women with PE/GH or GDM than in those with no APO. Risk factors perturbed after delivery in women with APOs were blood pressure, BMI, waist circumference, HDL-cholesterol, triglycerides, glucose, and HbA1c. Conclusion: While risk scores customized for women of reproductive age are needed, those with a first pregnancy complicated by PTB, PE/GH or GDM have modest but detectable predicted 10-year CVD risk as soon as 2-7 years after delivery.

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.

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

Periodontal Medicine: 100 Years of Progress

2019 ◽  
Vol 98 (10) ◽  
pp. 1053-1062 ◽  
Author(s):  
J.D. Beck ◽  
P.N. Papapanou ◽  
K.H. Philips ◽  
S. Offenbacher
Keyword(s):  
Cardiovascular Disease ◽  
Periodontal Disease ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Lessons Learned ◽  
Case Definitions ◽  
Medicine Research ◽  
Periodontal Infection ◽  
Adverse Pregnancy ◽  
Periodontal Medicine

Periodontal medicine is a term used to describe how periodontal infection/inflammation may impact extraoral health. Periodontitis has been linked to over 50 systemic diseases and conditions. As part of the Journal of Dental Research’s Centennial Celebration, this narrative review discusses periodontal medicine research done over the past 100 y, with particular focus on the effects of periodontal disease on 3 pathological conditions: cardiovascular disease, diabetes mellitus, and adverse pregnancy outcomes. We selected 29 total studies that were the “first” of their kind, as they provided novel observations or contributed to shifting paradigms as well as important studies that made strong contributions to progress in understanding relationships to the systemic conditions. These studies were organized in an overview timeline and broken down into timelines by topic: cardiovascular disease ( n = 10), diabetes ( n = 12), and adverse pregnancy outcomes ( n = 7). Overall, the majority of cross-sectional, case-control, and longitudinal studies have revealed positive associations between poor periodontal status and cardiovascular disease, diabetes metabolic control, and a number of adverse pregnancy outcomes, and these associations are upheld in systematic reviews. Findings from randomized controlled trials testing the effects of periodontal therapy on systemic health outcomes were conflicting and inconsistent. While there has been a great deal of progress, we highlight lessons learned and make comments and suggestions on a number of key aspects, including the heterogeneity of case definitions of periodontal disease across studies, accounting for features of the periodontal phenotype that are most relevant to the biological link between periodontitis and systemic outcomes, the role of other comorbid inflammatory conditions, selection of study participants, and timing and intensity of the periodontal intervention.

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