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Circulation
02 13, 2024;149 (7): e330-e346.

Opportunities in the Postpartum Period to Reduce Cardiovascular Disease Risk After Adverse Pregnancy Outcomes: A Scientific Statement From the American Heart Association.

Jennifer Lewey, Theresa M Beckie, Haywood L Brown, Susan D Brown, Vesna D Garovic, Sadiya S Khan, Eliza C Miller, Garima Sharma, Laxmi S Mehta, American Heart Association Cardiovascular Disease and Stroke in Women and Underrepresented Populations Committee of the Council on Clinical Cardiology; Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation; and Council on Cardiovascular and Stroke Nursing
Author Information
PMID: 38346104 DOI: 10.1161/CIR.0000000000001212

Abstract

Adverse pregnancy outcomes are common among pregnant individuals and are associated with long-term risk of cardiovascular disease. Individuals with adverse pregnancy outcomes also have an increased incidence of cardiovascular disease risk factors after delivery. Despite this, evidence-based approaches to managing these patients after pregnancy to reduce cardiovascular disease risk are lacking. In this scientific statement, we review the current evidence on interpregnancy and postpartum preventive strategies, blood pressure management, and lifestyle interventions for optimizing cardiovascular disease using the American Heart Association Life's Essential 8 framework. Clinical, health system, and community-level interventions can be used to engage postpartum individuals and to reach populations who experience the highest burden of adverse pregnancy outcomes and cardiovascular disease. Future trials are needed to improve screening of subclinical cardiovascular disease in individuals with a history of adverse pregnancy outcomes, before the onset of symptomatic disease. Interventions in the fourth trimester, defined as the 12 weeks after delivery, have great potential to improve cardiovascular health across the life course.

Keywords

AHA Scientific Statements cardiovascular diseases diabetes, gestational postpartum period pregnancy pregnancy complications primary prevention

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Grants

  1. R01 NS122815/NINDS NIH HHS
  2. UG3 OD035540/NIH HHS
  3. K23 HL153667/NHLBI NIH HHS
  4. K23 NS107645/NINDS NIH HHS
  5. R21 AG069111/NIA NIH HHS
  6. R21 HD110992/NICHD NIH HHS
  7. P30 DK092924/NIDDK NIH HHS
  8. R01 DK118455/NIDDK NIH HHS
  9. KL2 TR003099/NCATS NIH HHS
  10. K26 DK138246/NIDDK NIH HHS
  11. R01 HL142996/NHLBI NIH HHS
  12. R01 DK122087/NIDDK NIH HHS

MeSH Term

Pregnancy
Female
United States
Humans
Cardiovascular Diseases
American Heart Association
Postpartum Period
Pregnancy Outcome
Blood Pressure
Risk Factors
Journal Article Review
Article has an altmetric score of 257

Word Cloud

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