Preterm Birth and Maternal Cardiovascular Risk

Preterm birth (PTB) is increasingly recognised not only for its immediate perinatal risks but also as a significant predictor of long-term cardiovascular disease. Emerging evidence from large observational studies and meta-analyses demonstrates that women with a history of PTB face substantially higher risks of hypertension, diabetes, coronary heart disease, stroke and cardiovascular mortality, even after adjusting for conventional risk factors. In this review the available epidemiological evidence linking PTB to future cardiovascular risk is summarised, the proposed biological mechanisms, including persistent inflammation, endothelial dysfunction, oxidative stress, placental vascular abnormalities, and genetic or epigenetic alterations are explored, and their clinical implications are discussed. Finally, the authors outline recommendations consistent with the recent European Society of Cardiology and American Heart Association guidelines. Recognising PTB as an independent cardiovascular risk marker underscores the need to integrate obstetric history into cardiovascular risk assessment and prevention strategies. Incorporating obstetric history into routine care offers a crucial opportunity to improve cardiovascular outcomes and promote long-term health in women who experience PTB.