Complications in pregnancy may predict later chronic disease

The physiologic changes a woman's body undergoes in pregnancy is nothing short of miraculous. Her blood volume increases, her lungs have less space to expand, and her center of gravity shifts with her growing belly. It is a wonder to consider the changes the body can sustain to support pregnancy. However, sometimes, pregnancy can lead to complications like gestational hypertension (high blood pressure associated with pregnancy), gestational diabetes (high blood sugar associated with pregnancy), or preeclampsia (a multi-factorial disorder involving high blood pressure and sometimes lab derangements). Although pregnancy is limited in time, new research points to connections between pregnancy complications and chronic disease later in life.

Contemporary OBG/GYN published a fantastic review article this month about complications of pregnancy and the risk for chronic diseases such as diabetes and hypertension. Most interestingly, a women's OB history (including whether she had complications of pregnancy) is relevant to her healthcare for the rest of her life.

Some of the shocking statistics include:

- Having gestational diabetes carries a 12.7 fold increased risk of developing Type 2 Diabetes.

- Having severe preeclampsia carries a 9.5 fold increased risk of having a stroke, blood clot, heart attack, or Type 2 Diabetes by age 50.

- Having gestational hypertension carries a 5.3 fold increased risk of developing hypertension.

- Having a history of a baby born preterm (before 37 weeks) carries a 4.1 fold increased risk of atherosclerosis and a 1.7 fold increased risk of stroke.

- Having a small-for-gestational-age infant carries a 2.56 fold increased risk of death due to cardiovascular disease.

Some of the underlying causes of these incredible links could include genetics, obesity and metabolic syndrome, immune maladaptation, abnormalities in maternal blood flow, and/or dysfunction in the cells that line blood vessels.

Take Home Message: Throughout her life, a woman's obstetric history remains important in considering what screening, treatment, and counseling she requires to maintain her optimal state of health.