Pregnancy Complications Can Foreshadow Future Disease-Long-Term Outcomes of a Complicated Pregnancy.

Anca Marina Ciobanu,Anca Maria Panaitescu,Brindusa Ana Cimpoca-Raptis,Nicolae Gica,Mihaela Roxana Popescu

doi:10.3390/medicina57121320

Abstract

During gestation, the maternal body should increase its activity to fulfil the demands of the developing fetus as pregnancy progresses. Each maternal organ adapts in a unique manner and at a different time during pregnancy. In an organ or system that was already vulnerable before pregnancy, the burden of pregnancy can trigger overt clinical manifestations. After delivery, symptoms usually reside; however, in time, because of the age-related metabolic and pro-atherogenic changes, they reappear. Therefore, it is believed that pregnancy acts as a medical stress test for mothers. Pregnancy complications such as gestational hypertension, preeclampsia and gestational diabetes mellitus foreshadow cardiovascular disease and/or diabetes later in life. Affected women are encouraged to modify their lifestyle after birth by adjusting their diet and exercise habits. Blood pressure and plasmatic glucose level checking are recommended so that early therapeutic intervention can reduce long-term morbidity. Currently, the knowledge of the long-term consequences in women who have had pregnancy-related syndromes is still incomplete. A past obstetric history may, however, be useful in determining the risk of diseases later in life and allow timely intervention.

Highlights

During gestation, the maternal body should increase its activity in order to fulfil the demands of the developing fetus as pregnancy progresses
Gestational hypertension is associated with a higher risk of kidney disease or diabetes mellitus [38]
Universal gestational diabetes mellitus (GDM) screening should be considered [42], as women who had GDM in a previous pregnancy are at increased risk of developing type 2 diabetes mellitus (DM) later in life

Summary

Introduction

The maternal body should increase its activity in order to fulfil the demands of the developing fetus as pregnancy progresses. After 24 weeks, pregnancy-related complications are more prevalent These become apparent when the maternal organs are unable to compensate the demands that increase with an increase in gestational age. Age-related changes trigger a metabolic syndrome and pro-atherogenic state, leading to cardiovascular disease and diabetes mellitus (Figure 1). We acknowledge the limitations of the meta-analysis in terms of heterogeneity of the included studies and lack of long-term follow-up (Figure 3). We acknowledge the limit4ao-f 12 tions of the meta-analysis in terms of heterogeneity of the included studies and lack of long-term follow-up (Figure 3). AAftfeterroonneepprereggnnaannccyyccoommpplliiccaatteedd wwiitthh PPEE,, tthhee mmootthheerr hhaass aa ffoouurrffoolldd iinnccrreeaasseedd rriisskk of doevf edleovpeilnogpienngde-sntda-gsetargeenraelndailsedaisseeawseitwhiinth1in0 1y0eayresaarsftaefrtedredlievleivryer[y37[3]7. Afteftremr moroereththananone proeneeclparmeepctliacmppretigcnparnecgyn, aanlcoyw, -abilrotwhw-beirigthhwt beiagbhyt obraabyproertearmprbetiertrhminbcirrethasienscrtheaesmesotthheer’s risnihiromsniofkpaoukpretseAilhrvhddeAeeceocnerccbnluce’acusellyumafdrrucmrafipauhbrstptekttneeheitcccseicestkccvhrpicreoepreer[dnenc3ereek.eg7nfangeu]nifi.dnntrnaetagngahrncfeffctbiooreeiirerrs[rs3tPPbwh7wEEi]ri.,t,itlollphplirriimtedemovveppeiendrnrnoteotitvinfvioyeoteninfmtmyohoaroatrthdtseedoeerreslnnmaelaaaylmolyiltlnoooihntnntehhggrteehs--rttedsteeherrdtmmavheteavlctcneooonelpnoneemspsedeedmeqqfnuufeutuenreortntnthfchockeeeefirsrdsk.m.nmAiAdeoloynblnnbeudiiuyttmioomsderriniiiainnnsuseguge-arsoiaef kidney function

Gestational Hypertension and Future Cardiovascular Risks for Mothers

Gestational Diabetes Mellitus

Thrombosis during Pregnancy

Thyroid Disease in Pregnancy

Liver Disease

Future Perspectives in Understanding PE and the Long-Term Risks

Gestational Diabetes

Findings

10. Conclusions