Long-Term Effects of Pregnancy Complications on Maternal Health: A Review.

Ran Neiger

doi:10.3390/jcm6080076

Abstract

Background: Most pregnancy-related medical complications appear to resolve at delivery or shortly thereafter. Common examples are preterm labor, placental abruption, preeclampsia, and gestational diabetes. Women who developed such complications are known to be at increased risk of developing similar complications in future pregnancies. It has recently become evident that these women are at an increased risk of long term medical complications. Methods: A search through scientific publications in English regarding the association of obstetric complications and long-term maternal illness. Results: There is a clear association between various obstetric complications and long-term effects on maternal health. Conclusions: Women with a history of adverse pregnancy outcomes are at increased risk of cardiovascular and metabolic diseases later in life. Data increasingly links maternal vascular, metabolic, and inflammatory complications of pregnancy with an increased risk of vascular disease in later life.

Highlights

Most pregnancy-related medical complications appear to resolve at delivery or shortly thereafter.Common examples are preterm labor, placental abruption, preeclampsia, and gestational diabetes.Women who developed such complications are known to be at increased risk of developing similar complications in future pregnancies
Women who delivered prematurely are at increased risk of recurrent preterm labor, those who had preeclampsia have an increased risk of preeclampsia in subsequent pregnancies, women who developed gestational diabetes (GDM) are likely to develop it again, as are women who experienced placental abruption, fetal growth impairment, etc
Regardless of whether long-term maternal complications were caused by pregnancy or first recognized during pregnancy, this review summarizes current information regarding the association between the most common obstetric complications—gestational diabetes, preeclampsia, and pre-term labor—and their long term maternal effects

Summary

Introduction

Most pregnancy-related medical complications appear to resolve at delivery or shortly thereafter. Common examples are preterm labor, placental abruption, preeclampsia, and gestational diabetes Women who developed such complications are known to be at increased risk of developing similar complications in future pregnancies. Other researchers associated adverse pregnancy outcome, as well as the increased risk of vascular and metabolic diseases in later life, with placental malfunction, known as “Placental syndrome”. The placental vascular bed disease that underpinned these complications was commonly investigated with targeted biopsies In their published review, these researchers critically evaluated the biopsy technique to summarize the salient types of defective deep placentation. In 2015 Bronsens et al suggested that the major obstetric syndromes, including preeclampsia, fetal growth restriction, and spontaneous preterm labor caused by impaired placental bed spiral artery remodeling may be the result of impaired functional maturation of the uterus during the early reproductive years [6]. Many obstetricians and gynecologists are not familiar with this information since a great proportion of current research was published in journals other than the “traditional” obstetrics and gynecology literature

Gestational Diabetes

Preeclampsia

Preterm Deliveries

Other Obstetric Complications

Findings

Conclusions