Cardiovascular Risk During Pregnancy: Scoping Review on the Clinical Implications and Long-Term Consequences

Background/Objectives: Cardiovascular risk (CVR) during pregnancy is an increasingly relevant topic due to its clinical significance and impact on maternal and fetal health. Pregnancy involves substantial physiological changes that may result in adverse outcomes such as gestational hypertension, gestational diabetes, obesity, and preeclampsia. These complications not only increase morbidity and mortality during pregnancy and the early postpartum period but also predispose women to long-term cardiovascular disease (CVD). Therefore, accurate assessment of CVR during pregnancy is essential for identifying risk factors and implementing preventive and therapeutic strategies tailored to the unique physiological context of gestation. To examine CVR during pregnancy and its long-term consequences, addressing etiological, diagnostic, and therapeutic aspects to provide an integrative perspective on the relationship between cardiovascular alterations and pregnancy. Methods: A scoping review was conducted in accordance with PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Literature searches were performed in PubMed, Embase, and Scopus databases using terms related to pregnancy, cardiovascular diseases, and risk factors. The review covered studies published from 2019 to November 2024. A total of 205 articles were initially identified, of which 20 met the inclusion and exclusion criteria and were selected for analysis. Results: Pregnancy is considered a natural "cardiovascular stress test" that can unmask or trigger latent CVR factors. Complications such as preeclampsia, gestational diabetes, and intrauterine growth restriction are associated with a higher risk of developing CVD later in life. Genetic factors, such as telomere length, and specific biomarkers have emerged as promising tools for CVR assessment during pregnancy. Personalized management strategies-including regular monitoring and lifestyle modifications-have shown effectiveness in reducing both immediate CVR and the subsequent development of CVD, particularly in high-risk pregnancies. Conclusions: Pregnancy represents a unique window of opportunity for the early identification and management of CVR factors. These risk factors and obstetric complications have significant long-term implications, notably increasing the likelihood of future cardiovascular disease. Preventive and therapeutic interventions initiated during pregnancy are, therefore, crucial for improving maternal and neonatal outcomes and for reducing long-term cardiovascular morbidity.