Severe maternal morbidity and risk of cardiovascular disease: Recent advances

Pregnancy complications including severe maternal morbidity have been linked with an increased risk of cardiovascular disease, and provide opportunities to identify women who would benefit from prevention. Severe maternal morbidity comprises life-endangering complications around the time of pregnancy and delivery. Literature on the relationship between severe maternal morbidity and cardiovascular disease is increasing at a rapid pace. Studies have shown that severe preeclampsia or eclampsia and severe hemorrhage are associated with cardiovascular disease later in life. Proposed pathways include endothelial damage, hypercoagulability, and impaired cardiac function that are induced or exacerbated by severe pregnancy complications that elevate cardiovascular risks. However, less is known about other types of severe maternal morbidity that may influence the risk of cardiovascular disease. Other research gaps include a need to better understand the pathways and mechanisms linking severe maternal morbidity with cardiovascular disease, the potential for cardiovascular recovery after severe cardiovascular events during pregnancy, and disparities in the occurrence of cardiovascular disease after severe maternal morbidity.