Keele Research Repository

Globally, cardiovascular disease is the most common cause of mortality in women accounting for 1 in 3 deaths. There remains an under recognition of cardiovascular disease as well as a lack of awareness of risk in women. Promotion of cardiovascular disease prevention is essential, but the current risk assessment tools do not incorporate any sex-specific cardiovascular risk factors. There is increasing recognition of sex-specific risk factors that appear during pregnancy that are associated with cardiovascular disease. These adverse pregnancy outcomes include preeclampsia, gestational hypertension, preterm birth, gestational diabetes, delivery of a small-for-gestational-age infant, miscarriage and high parity number. Although the underlying biological mechanism for these association remains to be elucidated, current international guidelines are beginning to recommend the inclusion of adverse pregnancy outcomes in the assessment of cardiovascular disease risk in women. This review summarizes the evidence for the association between adverse pregnancy outcomes and future cardiovascular disease. It also highlights the importance of considering adverse pregnancy outcomes in the cardiovascular risk assessment, specifically in young women, allowing for targeted lifestyle modifying interventions with the potential to alter their risk trajectory and improve their long-term cardiovascular health.