Page 16 - Pro-active Management of Women’s Health after Cardiometabolic Complicated Pregnancies

14 | Part 1 Introduction
Figure 1.3. ‘Common soil’ theory of the origin of preeclampsia, fetal growth restriction and
cardiovascular disease
Pregnancy
Function
Demand Placenta
Oxidative stress Endothelial dysfunction Inflammation
Maternal factors Metabolic syndrome
Lifestyle Genetic predisposition Environment
?
Long term
Fetal
Growth restriction
Maternal
Preeclampsia
Atherosclerosis
Cardiovascular disease
Metabolic complications of pregnancy
Gestational diabetes mellitus complicates 8-10% of all pregnancies. Women with a pregnancy complicated by gestational diabetes mellitus, are at increased risk for future type 2 diabetes mellitus. The 5 to 15-years risk for diabetes is 33%-60%43-48, compared to 2-3% after uncomplicated pregnancy. The more severe gestational diabetes mellitus (early onset <24 weeks of gestation, need for insulin), the higher the risk of future diabetes mellitus43. Also, BMI in case of gestational diabetes mellitus is independently positively associated with the risk of future diabetes mellitus43 44 46 47.
Women with a history of gestational diabetes mellitus have a worse metabolic health compared to women with an uncomplicated pregnancy49. Fasting glucose levels are higher, as is BMI, lipid levels and blood pressure.