Page 14 - Pro-active Management of Women’s Health after Cardiometabolic Complicated Pregnancies

12 | Part 1 Introduction
Figure 1.1. Risk factors for cardiometabolic disease are identifiable during excursions into
the cardiometabolic syndrome of pregnancy (adapted from Sattar and Greer, 20021)
Population with complicated pregnancy Population with healthy pregnancy Threshold for cardiometabolic disease
Neonatal life
Pregnancies
Middle age
Age
without fetal growth restriction. Clinically preeclampsia is differentiated in severe (severe hypertension, fetal growth restriction, HELLP syndrome, early onset) and mild (mild hypertension, appropriate fetal growth, no HELLP syndrome, late onset) preeclampsia.
Already in 1976 Chelsey observed an increased mortality in former eclamptic women6. More recent studies show a 2-fold increased risk for future cardiovascular disease up to 30 years after preeclampsia2 3 7-16. More severe preeclampsia is associated with an even higher risk. If preeclampsia is combined with fetal growth restriction, the increase is 4-fold10. When fetal growth restriction is accompanied with premature birth, the risk is increased 16-fold10. As shown by Ray et al, this increased risk for cardiovascular disease is already observed the first decade after the pregnancy3 (figure 1.2).
Previous studies show a decreased cardiovascular health in formerly preeclamptic women17-27. They have higher blood pressure25 28-31, higher
Cardiometabolic health