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Published on: January 12, 2018
Cardiometabolic Risk Factors in Pregnancy and Implications for Long-Term Health: Identifying the Research Priorities
Shobhana Nagraj1,2, Stephen H Kennedy1, Robyn Norton2,3
1Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, United Kingdom.
Insights
Cardiometabolic disorders (CMDs) disproportionately affect women in low-resource settings. Early identification and postpartum follow-up of high-risk pregnancies can help prevent or delay CMDs.
Area of Science:
- Global Health
- Cardiology
- Obstetrics & Gynecology
Background:
- Cardiometabolic disorders (CMDs) are leading causes of death and illness in women globally.
- These disorders disproportionately impact low and middle-income countries (LMICs), presenting earlier and with higher fatality rates.
- Pregnancy complications like hypertensive disorders of pregnancy (HDPs) and gestational diabetes mellitus (GDM) signal increased future CMD risk.
Purpose of the Study:
- To review challenges in identifying and managing pregnant women at risk for CMDs in low-resource settings.
- To present evidence-based strategies, including novel diagnostics and technologies, for early detection and management.
- To highlight research priorities for addressing cardiometabolic risk during pregnancy in LMICs.
Main Methods:
- Mini-review of existing literature and evidence-based strategies.
- Focus on challenges in early identification, referral, and management.
- Exploration of novel diagnostics, technology, and innovations.
Main Results:
- Significant challenges exist in the early identification, referral, and management of pregnant women at risk for CMDs in LMICs.
- Evidence-based strategies and innovations are available for early detection and management.
- Key research priorities have been identified to address cardiometabolic risk in pregnancy.
Conclusions:
- Early identification and postpartum follow-up of women with pregnancy complications are crucial for CMD prevention or delay.
- Implementing innovative strategies and addressing research priorities are essential for improving outcomes in low-resource settings.
- Targeting cardiometabolic risk in pregnancy offers a vital window for intervention and long-term women's health improvement.
Abstract:
Cardiometabolic disorders (CMDs), including ischemic heart disease, stroke and type 2 diabetes are the leading causes of mortality and morbidity in women worldwide. The burden of CMDs falls disproportionately on low and middle-income countries (LMICs), placing substantial demands on already pressured health systems. Cardiometabolic disorders may present up to a decade earlier in some LMIC settings, and are associated with high-case fatality rates. Early identification and ongoing postpartum follow-up of women with pregnancy complications such as hypertensive disorders of pregnancy (HDPs), and gestational diabetes mellitus (GDM) may offer opportunities for prevention, or help delay onset of CMDs. This mini-review paper presents an overview of the key challenges faced in the early identification, referral and management of pregnant women at increased risk of CMDs, in low-resource settings worldwide. Evidence-based strategies, including novel diagnostics, technology and innovations for early detection, screening and management for pregnant women at high-risk of CMDs are presented. The review highlights the key research priorities for addressing cardiometabolic risk in pregnancy in low-resource settings.
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