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Published on: May 5, 2018

Perinatal Endocrine-Cardiac Axis: A Narrative Review of Long-Term Cardiovascular Risks in Women with Gestational

Ying Xie1, Beiyan Chen2, Shuang Gao2

  • 1School of Basic Medical Sciences, Heilongjiang University of Chinese Medicine, Harbin 150040, China.

Biomedicines
|June 26, 2026
PubMed

Insights

Women with gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP), and thyroid dysfunction face elevated long-term cardiovascular disease (CVD) risks. Early screening and interventions are crucial for prevention.

Area of Science:

  • Endocrinology
  • Cardiology
  • Obstetrics

Background:

  • Perinatal endocrine disorders like GDM, HDP, and thyroid dysfunction are common.
  • These conditions are increasingly recognized for their long-term health implications.

Purpose of the Study:

  • To review long-term cardiovascular disease (CVD) risks linked to GDM, HDP, and thyroid dysfunction.
  • To identify strategies for early risk stratification and prevention in affected women.

Main Methods:

  • Structured literature search of PubMed and Web of Science (2000-2025).
  • Prioritized prospective cohort studies, meta-analyses, systematic reviews, and guidelines.
  • Thematic synthesis of key findings on perinatal endocrine disorders and CVD.

Main Results:

  • GDM, HDP, and subclinical hypothyroidism significantly increase future CVD risk (1.6- to 2-fold).
  • Risks persist for decades, exacerbated by obesity and social determinants.
  • Shared pathophysiological pathways include insulin resistance, inflammation, and endothelial dysfunction.

Conclusions:

  • A life-course approach is essential for managing CVD risk post-pregnancy.
  • Structured postpartum screening, lifestyle interventions, and cardio-obstetrics programs are recommended.
  • Integrating pregnancy history into CVD risk assessment is critical for women's cardiovascular health.

Keywords:
cardiovascular diseaseendothelial dysfunctiongestational diabetes mellitushypertensive disorders of pregnancyinsulin resistanceplacentapostpartum thyroiditispreeclampsiathyroid dysfunctionwomen’s health

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