Pregnancy complications increase risk for premature CHD in adults

Margo B. Minissian, PhD, ACNP, CLS, AACC, FAHA

I thought these findings were very interesting. The first point that I want to make in regards to this study is that this was completed in Indonesia in very indigent areas, which is a very common instance worldwide. We see some of the highest rates of CVD in these very indigent parts of the world. When we’re looking at data that’s reflecting out of these communities, trying to implement and see what their meaning might be in more of a Westernized society may not always be as translatable.

There were a few points that were very important. The researchers saw in adult children of women who had an adverse pregnancy outcome lower levels of HDL, higher rates of diabetes and elevated glucose and also higher rates of smoking. This was despite the subjects being overweight or having elevated LDL. The main key message and where this body of evidence helps us is to reassure us that promoting heart-healthy lifestyles, especially those modifiable risk factors such as smoking and managing glucose, are imperative for us to help people who may be predisposed to future CV risk.  

The best way that you can translate these data for individuals in the United States is if you have a family member who’s had an adverse pregnancy outcome, these children may potentially have higher rates of metabolic syndrome. Applying what we already know about smoking cessation, managing our cholesterol, managing our BP and leading a heart-healthy lifestyle can help ward off ischemic heart disease.

It would be fascinating if we were able to unify our electronic medical records system. The main critique that I would have of this study is that they did not have electronic medical records. These participants were 47 years of age, so you’re trying to rely on recollection of a mother of what happened to her 47 years ago. We have fairly good data suggesting that recall of these women in their adverse pregnancy outcomes tends to be lower.

In the future, when we’re looking at population health in the community, it will be helpful to have systems where we are on the same page with the electronic medical records. That’s one thing that we’re trying to do in the United States. We’re trying to unify the language, and we’re also trying to document it in a unified way in the electronic medical records so that we can follow individuals long term.

It was a fairly straightforward article and an important one, in that so many things that we already know how to prevent are involved. These data support the fact that we know how to do a lot of these things, and if we implement prevention, we may be able to ward off future ischemic CVD risk.