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

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.

Pregnancy Complications Lead to Subclinical Maternal Heart Dysfunction—The Importance and Benefits of Follow-Up Using Speckle Tracking Echocardiography

“…Long-term studies are warrantied for this at-risk group, in order to establish the value of the method and create an appropriate follow-up protocol [36]. Closely monitored high-risk pregnancies [44,[78][79][80][81] will also lead to fewer fetal complications.…”

“…All these data support the coordinated use of speckle tracking by teams of maternal fetal specialists and cardiologists in patients with pregnancy complications, both pre and postpartum. The desired outcome would be to design tailored monitoring protocols for every clinical situation, in order to foresee possible long-term effects temporarily unmasked during pregnancy [81].…”

Association of pregnancy complications/risk factors with the development of future long-term health conditions in women: overarching protocol for umbrella reviews

“…During pregnancy, the maternal organs undergo significant physiological changes, such as increased cardiac output and inflammatory response due to the complications or risk factors, which can be reactivated by age-related changes in later life, resulting in development of long-term health conditions. [16][17][18][19] Women who have experienced pre-eclampsia have an increased risk of developing type 2 diabetes along with increased risk of hypertension, ischaemic heart disease, stroke and venous thromboembolism. [20][21][22][23] Depression and anxiety disorders are common after miscarriage, stillbirth and preterm births.…”

Physical Activity in Pregnancy was Favorably Associated with Maternal And Offspring Health Indices

“…During pregnancy, the female body experiences a set of cardiovascular, hormonal, and metabolic changes such as changes in maternal physiology, production of hormones by the fetus and placenta, and increased fetal metabolism [5]. Many of the physiological and metabolic changes observed during pregnancy (e.g., increased resting heart rate, cardiac output, respiratory rate, temperature, glucose utilization, and energy needs) also occur during PA [5]. In previous years, pregnant women were advised not to participate in PA based mainly based on empirical evidence [6].…”