Placenta-mediated Pregnancy Complications and Their Association With Maternal Cardiovascular Disease Risk Factors...

Placenta-mediated diseases (PMDs) are pregnancy complications that arise from abnormal placental development and/or function. PMDs are linked to elevated future cardiovascular disease (CVD) risk and represent a sex-specific indication for postpartum CVD risk screening. However, because implementation remains limited, optimized screening strategies are needed. In this study we aimed to review and synthesize evidence on postpartum CVD risk factors among women with a history of PMDs, across subtypes and postpartum time frames.

MEDLINE (Ovid), EMBASE (Ovid), CINAHL (EBSCOhost), and Scopus databases were searched from inception to July 2, 2024, for observational studies that assessed maternal CVD risk factors postpartum (via biochemical and clinical indicators) after a PMD-including preeclampsia, hemolysis elevated liver enzymes and low platelets (HELLP) syndrome, fetal growth restriction, small for gestational age, placental abruption, preterm birth, gestational diabetes, or stillbirth. Risk of bias was assessed using the Newcastle-Ottawa quality assessment tool.

Of 11,289 articles screened, 114 met inclusion criteria, predominantly cohort studies. Sample sizes ranged from 21 to 116,429 participants, with postpartum CVD risk factor assessment occurring between 1.4 months and 35 years after birth. Most studies examined preeclampsia and gestational diabetes; fewer addressed preterm birth, stillbirth, and placental abruption independently. All PMD types showed increased CVD risk markers at various postpartum intervals. At least 1 study per PMD reported suboptimal systolic blood pressure, body mass index, and total cholesterol.

Women with previous PMDs exhibit increased postpartum CVD risk markers. Detailed obstetric history should be integrated into generalized health and CVD-specific risk assessments.

CRD42022341291.