Hypertensive disorders of pregnancy and long‐term cardiovascular health: FIGO Best Practice Advice

Author:

Poon Liona C.1,Nguyen‐Hoang Long1,Smith Graeme N.2,Bergman Lina345,O'Brien Patrick6,Hod Moshe78,Okong Pius9,Kapur Anil10,Maxwell Cynthia V.11,McIntyre Harold David12,Jacobsson Bo1314,Algurjia Esraa1516,Hanson Mark A.1718,Rosser Mary L.19,Ma Ronald C.2021,O'Reilly Sharleen L.2223,Regan Lesley24,Adam Sumaiya2526,Medina Virna P.27,McAuliffe Fionnuala M.22,

Affiliation:

1. Department of Obstetrics and Gynecology Prince of Wales Hospital, The Chinese University of Hong Kong Hong Kong China

2. Department of Obstetrics and Gynecology, Kingston Health Sciences Centre Queen's University Kingston Ontario Canada

3. Department of Obstetrics and Gynecology, Institute of Clinical Sciences Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden

4. Department of Obstetrics and Gynecology Stellenbosch University Cape Town South Africa

5. Department of Women's and Children's Health Uppsala University Uppsala Sweden

6. Institute for Women's Health University College London London UK

7. Helen Schneider Hospital for Women Rabin Medical Center Petah Tikva Israel

8. Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel

9. Department of Obstetrics and Gynecology St Francis Hospital Nsambya Kampala City Uganda

10. World Diabetes Foundation Bagsvaerd Denmark

11. Maternal Fetal Medicine, Sinai Health and Women's College Hospital University of Toronto Toronto Ontario Canada

12. Mater Health University of Queensland, Mater Health Campus South Brisbane Queensland Australia

13. Department of Obstetrics and Gynecology Sahlgrenska University Hospital/Ostra Gothenburg Sweden

14. Department of Genetics and Bioinformatics, Domain of Health Data and Digitalisation Institute of Public Health Oslo Norway

15. The World Association of Trainees in Obstetrics & Gynecology Paris France

16. Elwya Maternity Hospital Baghdad Iraq

17. Institute of Developmental Sciences University Hospital Southampton Southampton UK

18. NIHR Southampton Biomedical Research Centre University of Southampton Southampton UK

19. Department of Obstetrics and Gynecology Columbia University Irving Medical Center, New York‐Presbyterian New York NY USA

20. Department of Medicine and Therapeutics The Chinese University of Hong Kong Hong Kong China

21. Hong Kong Institute of Diabetes and Obesity The Chinese University of Hong Kong Hong Kong China

22. UCD Perinatal Research Centre, School of Medicine University College Dublin, National Maternity Hospital Dublin Ireland

23. School of Agriculture and Food Science University College Dublin Dublin Ireland

24. Imperial College London London UK

25. Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences University of Pretoria Pretoria South Africa

26. Diabetes Research Centre, Faculty of Health Sciences University of Pretoria Pretoria South Africa

27. Department of Obstetrics and Gynecology, Faculty of Health Universidad del Valle, Clínica Imbanaco Quirón Salud, Universidad Libre Cali Colombia

Abstract

AbstractHypertensive 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.

Publisher

Wiley

Subject

Obstetrics and Gynecology,General Medicine

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