Abstract
Purpose of ReviewPregnancy can be seen as a “stress test” with complications predicting later-life cardiovascular disease risk. Here, we review the growing epidemiological literature evaluating environmental endocrine-disrupting chemical (EDC) exposure in pregnancy in relation to two important cardiovascular disease risk factors, hypertensive disorders of pregnancy and maternal obesity.Recent FindingsOverall, evidence of EDC-maternal cardiometabolic associations was mixed. The most consistent associations were observed for phenols and maternal obesity, as well as for perfluoroalkyl substances (PFASs) with hypertensive disorders. Research on polybrominated flame retardants and maternal cardiometabolic outcomes is limited, but suggestive.SummaryAlthough numerous studies evaluated pregnancy outcomes, few evaluated the postpartum period or assessed chemical mixtures. Overall, there is a need to better understand whether pregnancy exposure to these chemicals could contribute to adverse cardiometabolic health outcomes in women, particularly given that cardiovascular disease is the leading cause of death in women.
Highlights
During pregnancy, cardiometabolic, vascular, endocrine, and immune adaptations radically transform maternal physiology to support and nurture the developing fetus [1–3]
A greater appreciation of the magnitude of these physiological changes has led to the conceptualization of pregnancy as a “stress test,” with the mother’s ability to appropriately recalibrate to these changing demands providing a window into underlying cardiometabolic health [5–8]
We focus on two important cardiometabolic outcomes that have been assessed in this context across multiple studies: hypertensive disorders of pregnancy (HDP) and maternal obesity during and after pregnancy
Summary
Cardiometabolic, vascular, endocrine, and immune adaptations radically transform maternal physiology to support and nurture the developing fetus [1–3]. A greater appreciation of the magnitude of these physiological changes has led to the conceptualization of pregnancy as a “stress test,” with the mother’s ability to appropriately recalibrate to (and later, recuperate from) these changing demands providing a window into underlying cardiometabolic health [5–8]. From this perspective, pregnancy complications, such as hypertensive disorders of pregnancy (HDP), may be indicators of underlying metabolic and cardiovascular dysfunction, as well as predictors of future cardiometabolic disease risk. All of these outcomes are, in turn, associated with future cardiovascular disease (CVD), the leading cause of death in women [14, 15]
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