David Williams1. 1. Department of Academic Obstetrics and Gynaecology, Imperial College London, Chelsea and Westminster Hospital, London, UK. david.williams@imperial.ac.uk
Abstract
PURPOSE OF REVIEW: This review describes how the physiological demands of pregnancy act as a maternal stress test that can predict a woman's health in later life. Pregnancy transiently catapults a woman into a metabolic syndrome that predisposes to vascular endothelial dysfunction. Women who are already predisposed to this phenotype develop gestational hypertension or diabetes mellitus, which re-emerge in later life as the metabolic syndrome returns. Pregnancy can also temporarily unmask sub-clinical disease, which may return in later life when the effects of ageing diminish the limited reserves of a vulnerable organ. RECENT FINDINGS: Recent studies have attempted to assess how gestational syndromes affect the risk for a woman of developing a diverse range of diseases in later life. As well as cardiovascular disease and diabetes mellitus, pregnancy can reveal a vulnerability to thyroid and pituitary disorders, liver and renal disease, depression, thrombosis and even cancer. SUMMARY: Although our knowledge of this phenomenon is incomplete, women who have had gestational syndromes, in particular pregnancy-induced hypertension/preeclampsia or gestational diabetes, should make lifestyle changes that will reduce their risk of cardiovascular disease in later life.
PURPOSE OF REVIEW: This review describes how the physiological demands of pregnancy act as a maternal stress test that can predict a woman's health in later life. Pregnancy transiently catapults a woman into a metabolic syndrome that predisposes to vascular endothelial dysfunction. Women who are already predisposed to this phenotype develop gestational hypertension or diabetes mellitus, which re-emerge in later life as the metabolic syndrome returns. Pregnancy can also temporarily unmask sub-clinical disease, which may return in later life when the effects of ageing diminish the limited reserves of a vulnerable organ. RECENT FINDINGS: Recent studies have attempted to assess how gestational syndromes affect the risk for a woman of developing a diverse range of diseases in later life. As well as cardiovascular disease and diabetes mellitus, pregnancy can reveal a vulnerability to thyroid and pituitary disorders, liver and renal disease, depression, thrombosis and even cancer. SUMMARY: Although our knowledge of this phenomenon is incomplete, women who have had gestational syndromes, in particular pregnancy-induced hypertension/preeclampsia or gestational diabetes, should make lifestyle changes that will reduce their risk of cardiovascular disease in later life.
Authors: Whitney P Witt; Kristin Litzelman; Hilary A Spear; Lauren E Wisk; Nataliya Levin; Beth M McManus; Mari Palta Journal: Qual Life Res Date: 2011-12-10 Impact factor: 4.147
Authors: Patricia D Koman; Kelly A Hogan; Natalie Sampson; Rebecca Mandell; Chris M Coombe; Myra M Tetteh; Yolanda R Hill-Ashford; Donele Wilkins; Marya G Zlatnik; Rita Loch-Caruso; Amy J Schulz; Tracey J Woodruff Journal: World Med Health Policy Date: 2018-03-12