Maternal placental syndromes, include pre-eclampsia, high blood pressure during pregnancy, and conditions where the placental blood vessels become blocked. Probable maternal risk factors for placental syndromes--obesity, insulin resistance, high blood pressure, and raised blood lipids--are also independent predictors of adult-onset cardiovascular disease.
In the CHAMPS (Cardiovascular health after maternal placental syndromes) study Joel Ray (University of Toronto, Canada) and colleagues assessed the risk of premature cardiovascular disease in relation to maternal placental syndromes. The investigators recruited over 1 million women from Ontario, Canada, who were free from cardiovascular disease before their first documented pregnancy. 75 000 of the women were diagnosed with maternal placental syndrome. The researchers followed-up participants for an average of 9 years after giving birth and recorded the presence of cardiovascular disease. They found that women who had maternal placental syndrome had double the relative risk of premature cardiovascular disease (500 per million person-years in women who had maternal placental syndrome compared with 200 per million person-years in women who had not). The risk was further increased if the womans' baby had restricted growth or died in the womb, or if the woman had pre-existing risk factors for cardiovascular disease, such as tobacco smoking. The authors note that the findings do not imply a causal relation between maternal placental disorders in pregnancy and future cardiovascular disease.
Dr Ray states: "The risk of premature cardiovascular disease is higher after a maternal placental syndrome, especially when the fetus is adversely affected. Affected women should have their blood pressure and weight or waist measured about 6 months postpartum, and healthy lifestyle should be emphasised...We believe the maternal placental syndrome should be considered as an additional risk factor for cardiovascular disease in women."
"With a pandemic of obesity in our midst, including a more than doubling of the number of obese women at antenatal booking, we should try to ensure that women are a healthy weight before they enter reproductive years. In doing so, their future near risk of the metabolic syndrome, maternal placental syndromes, and cardiovascular disease might be reduced," he adds.
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