Consensus document of the SEGO and the CEIPV. Opportunity window: vascular risk prevention in women. Adverse pregnancy outcomes and risk of vascular disease
e202310084
Keywords:
Riesgo vascular, Embarazo, Postparto, Prevención de riesgoAbstract
This document summarises the evidence regarding the association between adverse pregnancy outcomes (APOs), such as hypertensive disorders, preterm birth, gestational diabetes, fetal growth defects (small for gestational age and/or fetal growth restriction), placental abruption, fetal loss, and the risk that a pregnant individual in developing vascular risk factors (VR) that may lead to future vascular disease (VD): coronary heart disease, stroke, peripheral vascular disease, and heart failure. Furthermore, this document emphasises the importance of recognising APOs when assessing VR in women. A history of APOs serves as a sufficient indicator for primary prevention of VD. In fact, adopting a healthy diet and increasing physical activity among women with APOs, starting during pregnancy and/or postpartum, and maintaining it throughout life are significant interventions that can reduce VR. On the other hand, breastfeeding can also reduce the future VR of women, including a lower risk of mortality.
Future studies evaluating the use of aspirin, statins, and metformin, among others, in women with a history of APOs could strengthen recommendations regarding pharmacotherapy for primary prevention of VD in these patients. Various healthcare system options exist to improve the transition of care for women with APOs between different healthcare professionals and implement long-term VR reduction strategies. One potential process could involve incorporating the fourth-trimester concept into clinical recommendations and healthcare policies.
Downloads
References
Zeng Z, Liu F, Li S. Metabolic Adaptations in Pregnancy: A Review. Ann Nutr Metab. 2017;70:59-65.
Gillespie SL, Porter K, Christian LM. Adaptation of the inflammatory immune response across pregnancy and postpartum in Black and White women. J Reprod Immunol. 2016;114:27-31.
Lane-Cordova AD, Khan SS, Grobman WA, Greenland P, Shah SJ. Long-Term Cardiovascular Risks Associated With Adverse Pregnancy Outcomes. J Am Coll Cardiol. 2019;73:2106-2116.
ACOG Practice Bulletin. Gestational Hypertension and Preeclampsia. Obstetrics & Gynecology. 2020;135:e237-260.
Wallis AB, Saftlas AF, Hsia J, Atrash HK. Secular Trends in the Rates of Preeclampsia, Eclampsia, and Gestational Hypertension, United States, 1987-2004. Am J Hypertens. 2008;21:521-526.
Centers for Disease Control (CDC). Gestational Diabetes. 2020 (consultado 11 de junio 2023).
Ananth C V., Keyes KM, Hamilton A, Gissler M, Wu C, Liu S et al. An International Contrast of Rates of Placental Abruption: An Age-Period-Cohort Analysis. PLoS One. 2015;10:e0125246.
Osterman MJK, Hamilton BE, Martin JA, Driscoll AK, Valenzuela CP. Births: Final Data for 2021. Natl Vital Stat Rep. 2023;72:1-53.
Aris IM, Kleinman KP, Belfort MB, Kaimal A, Oken E. A 2017 US Reference for Singleton Birth Weight Percentiles Using Obstetric Estimates of Gestation. Pediatrics. 2019;144:e2019076
Doty MS, Chen HY, Sibai BM, Chauhan SP. Maternal and Neonatal Morbidity Associated With Early Term Delivery of Large-for-Gestational-Age But Nonmacrosomic Neonates. Obstetrics & Gynecology. 2019;133:1160-1166.
Grandi SM, Filion KB, Yoon S, Ayele HT, Doyle CM, Hutcheon JA et al. Cardiovascular Disease-Related Morbidity and Mortality in Women With a History of Pregnancy Complications. Circulation. 2019;139:1069-1079.
Parikh NI, Gonzalez JM, Anderson CAM, Judd SE, Rexrode KM, Hlatky MA et al. Adverse Pregnancy Outcomes and Cardiovascular Disease Risk: Unique Opportunities for Cardiovascular Disease Prevention in Women: A Scientific Statement From the American Heart Association. Circulation. 2021;143(18).
Visseren FLJ, Mach F, Smulders YM, Carballo D, Koskinas KC, Bäck M et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2021;42:3227-3337.
Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, Blumenthal RS et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;139(25).
Markovitz AR, Stuart JJ, Horn J, Williams PL, Rimm EB, Missmer SA et al. Does pregnancy complication history improve cardiovascular disease risk prediction? Findings from the HUNT study in Norway. Eur Heart J. 2019;40:1113-1120.
Riise HKR, Sulo G, Tell GS, Igland J, Egeland G, Nygard O et al. Hypertensive pregnancy disorders increase the risk of maternal cardiovascular disease after adjustment for cardiovascular risk factors. Int J Cardiol. 2019;282:81-87.
Riise HKR, Sulo G, Tell GS, Igland J, Nygård O, Iversen A et al. Association Between Gestational Hypertension and Risk of Cardiovascular Disease Among 617 589 Norwegian Women. J Am Heart Assoc. 2018;7;e008337
Theilen LH, Meeks H, Fraser A, Esplin MS, Smith KR, Varner MW. Long-term mortality risk and life expectancy following recurrent hypertensive disease of pregnancy. Am J Obstet Gynecol. 2018;219:107.e1-107.e6.
Stuart JJ, Tanz LJ, Cook NR, Spiegelman D, Missmer SA, Rimm EB et al. Hypertensive Disorders of Pregnancy and 10-Year Cardiovascular Risk Prediction. J Am Coll Cardiol. 2018;72:1252-1263.
Kramer CK, Campbell S, Retnakaran R. Gestational diabetes and the risk of cardiovascular disease in women: a systematic review and meta-analysis. Diabetologia. 2019;62:905-914.
Turi V, Iurciuc S, Cretu OM, Tit DM, Bungau S, Apostol A et al. Arterial function in hypertensive pregnant women. Is arterial stiffness a marker for the outcomes in pregnancy? Life Sci. 2021, 264, 118723.
Tanz LJ, Stuart JJ, Williams PL, Missmer SA, Rimm EB, James-Todd TM et al. Preterm Delivery and Maternal Cardiovascular Disease Risk Factors: The Nurses’ Health Study II. J Womens Health. 2019;28:677-685.
Arnold L, Hoy W, Wang Z. Low birthweight increases risk for cardiovascular disease hospitalisations in a remote Indigenous Australian community-a prospective cohort study. Aust N Z J Public Health. 2016r;40:S102-106.
Morken NH, Halland F, DeRoo L, Wilcox A, Skjaerven R. Offspring birthweight by gestational age and parental cardiovascular mortality: a population-based cohort study. BJOG. 2018;123:336-341.
Hall PS, Nah G, Vittinghoff E, Parker DR, Manson JE, Howard BV et al. Relation of Pregnancy Loss to Risk of Cardiovascular Disease in Parous Postmenopausal Women (From the Women’s Health Initiative). Am J Cardiol. 2019;123:1620-1625.
Peters SA, Woodward M. Women’s reproductive factors and incident cardiovascular disease in the UK Biobank. Heart. 2018;104:1069-1075.
Brown MC, Best KE, Pearce MS, Waugh J, Robson SC, Bell R. Cardiovascular disease risk in women with pre-eclampsia: systematic review and meta-analysis. Eur J Epidemiol. 2013;28(1):1-19.
Hermes W, Ket JCF, van Pampus MG, Franx A, Veenendaal MVE, Kolster C et al. Biochemical Cardiovascular Risk Factors After Hypertensive Pregnancy Disorders. Obstet Gynecol Surv. 2012;67:792-808.
Vounzoulaki E, Khunti K, Abner SC, Tan BK, Davies MJ, Gillies CL. Progression to type 2 diabetes in women with a known history of gestational diabetes: systematic review and meta-analysis. BMJ. 2020;m1361.
Rayanagoudar G, Hashi AA, Zamora J, Khan KS, Hitman GA, Thangaratinam S. Quantification of the type 2 diabetes risk in women with gestational diabetes: a systematic review and meta-analysis of 95,750 women. Diabetologia. 2016;59:1403-1411.
Parikh NI, Norberg M, Ingelsson E, Cnattingius S, Vasan RS, Domellöf M et al. Association of Pregnancy Complications and Characteristics with Future Risk of Elevated Blood Pressure. Hypertension. 2017;69:475-483.
Fraser A, Nelson SM, Macdonald-Wallis C, Cherry L, Butler E, Sattar N et al. Associations of Pregnancy Complications with Calculated Cardiovascular Disease Risk and Cardiovascular Risk Factors in Middle Age. Circulation. 2012;125:1367-1380.
Sociedad Española de Diabetes (SED) Sociedad Española de Ginecología y Obstetricia (SEGO). Asistencia a la gestante con diabetes. Guía de práctica clínica actualizada. Av Diabetol. 2015;31(2):45-49.
Haas DM, Parker CB, Marsh DJ, Grobman WA, Ehrenthal DB, Greenland P et al. Association of Adverse Pregnancy Outcomes with Hypertension 2 to 7 Years Postpartum. J Am Heart Assoc. 2019;8(19).
Cortés YI, Catov JM, Brooks M, Harlow SD, Isasi CR, Jackson EA et al. History of Adverse Pregnancy Outcomes, Blood Pressure, and Subclinical Vascular Measures in Late Midlife: SWAN (Study of Women’s Health Across the Nation). J Am Heart Assoc. 2018;7(1).
Catov JM, Dodge R, Yamal JM, Roberts JM, Piller LB, Ness RB. Prior Preterm or Small-for-Gestational-Age Birth Related to Maternal Metabolic Syndrome. Obstetrics & Gynecology. 2011;117:225-232.
Horn J, Tanz L, Stuart J, Markovitz A, Skurnik G, Rimm E et al. Early or late pregnancy loss and development of clinical cardiovascular disease risk factors: a prospective cohort study. BJOG. 2019;126:33-42.
Parikh NI, Jeppson RP, Berger JS, Eaton CB, Kroenke CH, LeBlanc ES et al. Reproductive Risk Factors and Coronary Heart Disease in the Women’s Health Initiative Observational Study. Circulation. 2016;133:2149-2158.
Timpka S, Fraser A, Schyman T, Stuart JJ, Åsvold BO, Mogren I et al. The value of pregnancy complication history for 10-year cardiovascular disease risk prediction in middle-aged women. Eur J Epidemiol. 2018;33:1003-1010.
Brotons C, Camafort M, Castellanos MM, Clarà A, Cortés O et al. Comentario del CEIPVC a las nuevas guías europeas de prevención cardiovascular 2021. Rev Esp Salud Publica 2022;96:1 de marzo. E1-e14.
OMS. “Mejores inversiones” y otras intervenciones recomendadas para la prevención y el control de las enfermedades no transmisibles, 2017. Consultado 11 de Junio 2023. Disponible en: https:// apps.who.int/iris/bitstream/handle/10665/259351/WHO-NMH-NV1-17.9-spa.pdf.sequence-1
Organización Panamericana de la Salud. El paquete técnico SAFER. Un mundo libre de los daños relacionados con el alcohol. Washington: 2020. Consultado 11 de Junio 2023. Disponible en: https://iris.paho.org/bitstream/handkle/10665.2/51867/9879275321959_spa.pdf-sequence-5&isAllowed-y
World Health Organization. WHO global air quality guidelines. Particulate matter (PM2.5 and PM10), ozone, nitrogen dioxide, sulfur dioxide and carbon monoxide. Ginebra: WHO; 2021. Consultado 12 Junio 2023. Disponible en: https://apps.who.int/iris/handle/10665/345329
Ministerio de Sanidad. Consumo de alcohol; Información para decisores politicos. ¿Qué pueden hacer las administraciones públicas? 2021. Consultado 11 de Junio 2023. Disponible en: https://www.sanidad.gob.es/profesionales/saludPublica/prevPromoción/Prevencion/alcohol/docs(ConsumoAlcohol. DecisoresPoliticos.pdf
Floud S, Blangiardo M, Clarck C, de Hoogh K, Babisch W, Houthuijs D et al. Exposure to aircraft and road traffic noise and association with heart disease and stroke in six European countries: a cross-sectional study. Environ Health 2013;123:89. Doi: https://dx.doi.org/10.1186/1476-069X-12-89. PMID: 24131577; PMCID: PMC4015897.
Martínez-González MA, Salas-Salvadó J, Estruch R, Corella D, Fitó M, Ros E; PREDIMED INVESTIGATORS. Benefits of the Mediterranean Diet: Insights From the PREDIMED Study. Prog Cardiovasc Dis. 2015;58:50-60.
El Convenio Marco de la OMS para el control del Tabaco. Consultado 12 de junio de 2023.Disponible en: https://apps.who.int/iris/bitstream/handle/10665/42813/9243591010.pdf?sequence=1
Powell-Wiley TM, Baumer Y, Baah FO, Baez AS, Farmer N, Mahlobo CT et al. Social Determinants of Cardiovascular Disease. Circ Res. 2022;130:782-799.
Diez Roux AV. Residential Environments and Cardiovascular Risk. J Urban Health. 2003;80:569-589.
Institute of Medicine. Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. National Academies Press; 2006. Consultado 12 de junio 2023, disponible en: https://nap.nationalacademies.org/read/11537/chapter/1#ii
Courtney AU, O’Brien EC, Crowley RK, Geraghty AA, Brady MB, Kilbane MT, Twomey PJ, McKenna MJ, McAuliffe FM. DASH (Dietary Approaches to Stop Hypertension) dietary pattern and maternal blood pressure in pregnancy. J Hum Nutr Diet. 2020;33:686-697.
Mijatovic-Vukas J, Capling L, Cheng S, Stamatakis E, Louie J, Cheung N et al. Associations of Diet and Physical Activity with Risk for Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis. Nutrients. 2018;10:698.
Ziaei S, Norrozi M, Faghihzadeh S, Jafarbegloo E. A randomised placebo-controlled trial to determine the effect of iron supplementation on pregnancy outcome in pregnant women with haemoglobin ≥13.2 g/dl. BJOG. 2007;114:684-852.
Eckel RH, Jakicic JM, Ard JD, de Jesus JM, Miller NH, Hubbard VS et al. 2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk. Circulation. 2014;129:2960-2984.
Eshriqui I, Vilela AAF, Rebelo F, Farias DR, Castro MBT, Kac G. Gestational dietary patterns are not associated with blood pressure changes during pregnancy and early postpartum in a Brazilian prospective cohort. Eur J Nutr. 2016;55:21-32.
Dirección General de Salud Pública. Ministerio de Sanidad y Consumo. Recomendaciones sobre suplementación con ácido fólico para la prevención de defectos del tubo neural. Inf Ter Sist Nac Salud. 2001;25(66).
Farpour-Lambert NJ, Ells LJ, Martinez de Tejada B, Scott C. Obesity and Weight Gain in Pregnancy and Postpartum: an Evidence Review of Lifestyle Interventions to Inform Maternal and Child Health Policies. Front Endocrinol (Lausanne).2018;9:546
Mamun AA, O’Callaghan M, Callaway L, Williams G, Najman J, Lawlor DA. Associations of Gestational Weight Gain With Offspring Body Mass Index and Blood Pressure at 21 Years of Age. Circulation. 2009;119:1720-1727.
Gaillard R, Santos S, Duijts L, Felix JF. Childhood Health Consequences of Maternal Obesity during Pregnancy: A Narrative Review. Ann Nutr Metab. 2016;69:171-180.
Poston L, Caleyachetty R, Cnattingius S, Corvalán C, Uauy R, Herring S et al. Preconceptional and maternal obesity: epidemiology and health consequences. Lancet Diabetes Endocrinol. 2016;4:1025-1036.
Muktabhant B, Lawrie TA, Lumbiganon P, Laopaiboon M. Diet or exercise, or both, for preventing excessive weight gain in pregnancy. Cochrane Database of Systematic Reviews. 2015;2015(6).
Ministerio de Sanidad. Estrategia de Promoción de la Salud y Prevención en el SNS. 2013. Consultado el 12 de Junio 2023. Disponible en: https://www.sanidad.gob.es/areas/promocionPrevencion/estrategiaSNS/home.htm
Evenson KR, Barakat R, Brown WJ, Dargent-Molina P, Haruna M, Mikkelsen EM et al. Guidelines for Physical Activity during Pregnancy: Comparisons From Around the World. Am J Lifestyle Med. 2014;8:102-121.
US Department of Health and Human Services. Physical Activity Guidelines for Americans, 2nd edition. Department of Health and Human Services; 2018. Consultado el 12 de Junio de 2023. Disponible en: https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf
ACOG. Committee Opinion No. 549. Obstetrics & Gynecology. 2013;121:213-217.
Borrell LN, Rodriguez-Alvarez E, Savitz DA, Baquero MC. Parental Race/Ethnicity and Adverse Birth Outcomes in New York City: 2000–2010. Am J Public Health. 2016;106:1491-1497.
Appelman Y, van Rijn BB, ten Haaf ME, Boersma E, Peters SAE. Sex differences in cardiovascular risk factors and disease prevention. Atherosclerosis. 2015;241:211-218.
ACOG. Practice Bulletin No. 202: Gestational Hypertension and Preeclampsia. Obstetrics & Gynecology. 2019;133:1-1.
Hedderson M, Ehrlich S, Sridhar S, Darbinian J, Moore S, Ferrara A. Racial/Ethnic Disparities in the Prevalence of Gestational Diabetes Mellitus by BMI. Diabetes Care. 2012;35:1492-1498.
Shahul S, Tung A, Minhaj M, Nizamuddin J, Wenger J, Mahmood E et al. Racial Disparities in Comorbidities, Complications, and Maternal and Fetal Outcomes in Women With Preeclampsia/eclampsia. Hypertens Pregnancy. 2015;34:506-515.
Harville EW, Myers L, Shu T, Wallace ME, Bazzano LA. Pre-pregnancy cardiovascular risk factors and racial disparities in birth outcomes: the Bogalusa Heart Study. BMC Pregnancy Childbirth. 2018;18:339.
Parker DR, Lu B, Sands-Lincoln M, Kroenke CH, Lee CC, O’Sullivan M et al. Risk of Cardiovascular Disease Among Postmenopausal Women with Prior Pregnancy Loss: The Women’s Health Initiative. The Annals of Family Medicine. 2014;12:302-309.
Cirillo PM, Cohn BA. Pregnancy Complications and Cardiovascular Disease Death. Circulation. 2015;132:1234-1242.
Rosenberg L, Adams-Campbell L, Palmer JR. The Black Women’s Health Study: a follow-up study for causes and preventions of illness. J Am Med Womens Assoc (1972). 1995;50:56-58.
Stuebe AM, Rich-Edwards JW. The reset hypothesis: lactation and maternal metabolism. Am J Perinatol 2009;26:81-88
Nguyen B, JIn K, Ding D. Breastfeeding and maternal cardiovascular risk factors and outcomes: a siystematic review. PLoS One 2017;12:e0187923
Gunderson EP, Kim C, Quesenberry CP Jr, Marcovina S, Walton D, Azevedo Ram Fox G, Elmasian C, Young S, Salvador N et al. Lactation intensity and fasting plasma lipids, lipoproteins, non-esterified free fatty acids, leptin and adiponectin in postpartum women with recent gestational diabetes mellitus: the SWIFT cohort. Obstet Gynecol 2013;122:111-119
Bartick MC, Stuebe AM, Schwarz EB, Luongo C, Reinhold AG, Foster EM. Cost analysis of maternal disease associated with suboptimal breastfeeding. Obstet Gynecol 2013;122:111-119
Gunderson EP, Lewis CE, Wei GS, Whitmer RA, Quesenberry CP, Sidney S. Lactation and Changes in Maternal Metabolic Risk Factors. Obstetrics & Gynecology. 2007;109:729-738.
Ajmera VH, Terrault NA, VanWagner LB, Sarkar M, Lewis CE, Carr JJ et al. Longer lactation duration is associated with decreased prevalence of non-alcoholic fatty liver disease in women. J Hepatol. 2019;70:126-132.
Gunderson EP, Quesenberry CP, Ning X, Jacobs DR, Gross M, Goff DC et al. Lactation Duration and Midlife Atherosclerosis. Obstetrics & Gynecology. 2015;126:381-390.
Bonifacino E, Schwartz EB, Jun H, Wessel CB, Corbelli JA. Effect of Lactation on Maternal Hypertension: A Systematic Review. Breastfeeding Medicine. 2018;13:578-588.
Qu G, Wang L, Tang X, Wu W, Sun Y. Association Between Duration of Breastfeeding and Maternal Hypertension: A Systematic Review and Meta-Analysis. Breastfeeding Medicine. 2018;13:318-326.
Chetwynd EM, Stuebe AM, Rosenberg L, Troester M, Rowley D, Palmer JR. Cumulative Lactation and Onset of Hypertension in African-American Women. Am J Epidemiol. 2017;186:927-934.
Tschiderer L, Seekircher L, Kunutsor SK, Peters SAE, O’Keeffe LM, Willeit P. Breastfeeding Is Associated with a Reduced Maternal Cardiovascular Risk: Systematic Review and Meta-Analysis Involving Data From 8 Studies and 1 192 700 Parous Women. J Am Heart Assoc. 2022;11(2).
Gunderson EP, Lewis CE, Lin Y, Sorel M, Gross M, Sidney S et al. Lactation Duration and Progression to Diabetes in Women Across the Childbearing Years. JAMA Intern Med. 2018;178:328.
Peters SAE, Yang L, Guo Y, Chen Y, Bian Z, Du J et al. Breastfeeding and the Risk of Maternal Cardiovascular Disease: A Prospective Study of 300 000 Chinese Women. J Am Heart Assoc. 2017;6: e006081
Peters SA, van der Schouw YT, Wood AM, Sweeting MJ, Moons KG, Weiderpass E et al. Parity, breastfeeding and risk of coronary heart disease: A pan-European case-cohort study. Eur J Prev Cardiol. 2016;23:1755-1765.
Kirkegaard H, Bliddal M, Støvring H, Rasmussen KM, Gunderson EP, Køber L et al. Breastfeeding and later maternal risk of hypertension and cardiovascular disease-The role of overall and abdominal obesity. Prev Med (Baltim). 2018;114:140-148.
Nguyen B, Gale J, Nassar N, Bauman A, Joshy G, Ding D. Breastfeeding and Cardiovascular Disease Hospitalization and Mortality in Parous Women: Evidence From a Large Australian Cohort Study. J Am Heart Assoc. 2019;8:e011056
Natland Fagerhaug T, Forsmo S, Jacobsen GW, Midthjell K, Andersen LF, Ivar Lund Nilsen T. A prospective population-based cohort study of lactation and cardiovascular disease mortality: the HUNT study. BMC Public Health. 2013;13:1070.
LoVerde B, Falck A, Donohue P, Hussey-Gardener B. Supports and Barriers to the Provision of Human Milk by Mothers of African American Preterm Infants. Advances in Neonatal Care. 2018;18:179-188.
Burgess A, McDowell W, Ebersold S. Association Between Lactation and Postpartum Blood Pressure in Women with Preeclampsia. MCN: The American Journal of Maternal/Child Nursing. 2019 Mar;44:86-93.
Yu J, Pudwell J, Dayan N, Smith GN. Postpartum Breastfeeding and Cardiovascular Risk Assessment in Women Following Pregnancy Complications. J Womens Health. 2020;29:627-635.
Countouris ME, Schwarz EB, Rossiter BC, Althouse AD, Berlacher KL, Jeyabalan A et al. Effects of lactation on postpartum blood pressure among women with gestational hypertension and preeclampsia. Am J Obstet Gynecol. 2016;215:241.e1-241.e8.
Gunderson EP, Hurston SR, Dewey KG, Faith MS, Charvat-Aguilar N, Khoury VC et al. The study of women, infant feeding and type 2 diabetes after GDM pregnancy and growth of their offspring (SWIFT Offspring study): prospective design, methodology and baseline characteristics. BMC Pregnancy Childbirth. 2015;15:150.
Aroda VR, Christophi CA, Edelstein SL, Zhang P, Herman WH, Barrett-Connor E et al. The Effect of Lifestyle Intervention and Metformin on Preventing or Delaying Diabetes Among Women with and Without Gestational Diabetes: The Diabetes Prevention Program Outcomes Study 10-Year Follow-Up. J Clin Endocrinol Metab. 2015;100:1646-1653.
Ratner RE, Christophi CA, Metzger BE, Dabelea D, Bennett PH, Pi-Sunyer X et al. Prevention of Diabetes in Women with a History of Gestational Diabetes: Effects of Metformin and Lifestyle Interventions. J Clin Endocrinol Metab. 2008;93:4774-4779.
Syngelaki A, Nicolaides KH, Balani J, Hyer S, Akolekar R, Kotecha R et al. Metformin versus Placebo in Obese Pregnant Women without Diabetes Mellitus. New England Journal of Medicine. 2016;374:434-443.
Romero R, Erez O, Hüttemann M, Maymon E, Panaitescu B, Conde-Agudelo A et al. Metformin, the aspirin of the 21st century: its role in gestational diabetes mellitus, prevention of preeclampsia and cancer, and the promotion of longevity. Am J Obstet Gynecol. 2017;217:282-302.
Miller EC, Boehme AK, Chung NT, Wang SS, Lacey JV, Lakshminarayan K et al. Aspirin reduces long-term stroke risk in women with prior hypertensive disorders of pregnancy. Neurology. 2019;92:e305-316.
NICE GUIDELINES. Hypertension in Pregnancy: Diagnosis and Management. 2019. Consultado el 11 de Junio de 2023. Disponible en: https://www.nice.org.uk/guidance/ng133
McKinney J, Keyser L, Clinton S, Pagliano C. ACOG Committee Opinion No. 736: Optimizing Postpartum Care. Obstetrics & Gynecology. 2018;132:784-785.
Gamble DT, Brikinns B, Myint PK, Bhattacharya S. Hypertensive Disorders of Pregnancy and Subsequent Cardiovascular Disease: Current National and International Guidelines and the Need for Future Research. Front Cardiovasc Med. 2019;6:55
Khan SS, Cameron NA, Lindley KJ. Pregnancy as an Early Cardiovascular Moment: Peripartum Cardiovascular Health. Circ Res. 2023;132:1584-1606.
Parikh NI, Gonzalez JM, Anderson CAM, Judd SE, Rexrode KM, Hlatky MA et al; American Heart Association Council on Epidemiology and Prevention; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular and Stroke Nursing; and the Stroke Council. Adverse Pregnancy Outcomes and Cardiovascular Disease Risk: Unique Opportunities for Cardiovascular Disease Prevention in Women: A Scientific Statement From the American Heart Association. Circulation. 2021;143:e902-e916.
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2023 María Goya, Marta Miserachs, Anna Suy Franch, Jorge Burgos, María de la Calle, Carlos Brotons, Mar Castellanos, Olga Cortés Rico, Ángel Díaz Rodriguez, Roberto Elosúa, María del Mar Freijo, María González Fondado, Manuel Gorostidi, María Grau, Antonio M. Hernández Martínez, Carlos Lahoz, Nuria Muñoz-Rivas, Vicente Pallares-Carratalá, Juan Pedro-Botet, Enrique Rodilla, Miguel Ángel Royo Bordonada, Rafael Santamaría, Mónica Torres Fonseca, Aina Velescu, Alberto Zamora, Pedro Armario
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Usted es libre de:
Compartir — copiar y redistribuir el material en cualquier medio o formato.
La licenciante no puede revocar estas libertades en tanto usted siga los términos de la licencia.
Bajo los siguientes términos:
Atribución — Usted debe dar crédito de manera adecuada , brindar un enlace a la licencia, e indicar si se han realizado cambios. Puede hacerlo en cualquier forma razonable, pero no de forma tal que sugiera que usted o su uso tienen el apoyo de la licenciante.
NoComercial — Usted no puede hacer uso del material con propósitos comerciales.
SinDerivadas — Si remezcla, transforma o crea a partir del material, no podrá distribuir el material modificado.
No hay restricciones adicionales — No puede aplicar términos legales ni medidas tecnológicas que restrinjan legalmente a otras a hacer cualquier uso permitido por la licencia.
Avisos:
No tiene que cumplir con la licencia para elementos del material en el dominio público o cuando su uso esté permitido por una excepción o limitación aplicable.
No se dan garantías. La licencia podría no darle todos los permisos que necesita para el uso que tenga previsto. Por ejemplo, otros derechos como publicidad, privacidad, o derechos morales pueden limitar la forma en que utilice el material.
