Adverse pregnancy outcomes — hypertensive disorders, gestational diabetes, preterm birth, SGA — complicate nearly one in five pregnancies and are associated with both short- and long-term maternal CV risk. This review consolidates the growing consensus that pregnancy is a natural stress test and the postpartum period an opportunistic window for targeted CV risk screening and lifestyle counselling. It argues for formally embedding pregnancy history into cardiovascular risk assessment.
Pregnancy is well recognized as a critical period in a woman’s life course when physiologic changes intended to support the growing fetus can have adverse sequelae for long-term cardiovascular health. Adverse pregnancy outcomes are rising in prevalence, complicate nearly 1 in 5 pregnancies in the US, and include hypertensive disorders of pregnancy, gestational diabetes, preterm birth, and having a small-for-gestational-age infant. Ample observational data demonstrate that these adverse pregnancy outcomes are associated with increased maternal risk of cardiovascular disease (CVD) in the short and long term. As a result, pregnancy is commonly referred to as a stress test, which provides a window to future cardiovascular health for women. This knowledge has led to growing calls by national and international professional societies to recognize pregnancy and the postpartum period as opportunistic moments for CVD risk assessment and cardiovascular health counseling. This recognition of the i
