Pregnancy complications and maternal cardiovascular risk: opportunities for intervention and screening?

The link between defective nutrition of the fetus and vascular disease in later life is now well established. Naveed Sattar and Ian Greer report on the intriguing probability that complications in pregnancy also predispose mothers to later vascular and metabolic disease

Plentiful evidence now links low birth weight due to intrauterine growth restriction and increased risk of vascular disease in later adult life. This is considered to be partly the result of programming through fetal nutrition.1 In contrast, much less attention has been focused on the relation between adverse pregnancy outcomes, such as pre-eclampsia, gestational diabetes, preterm delivery, and intrauterine growth restriction, and the mother's subsequent health, and interesting data are now increasingly linking the maternal vascular, metabolic, and inflammatory complications of pregnancy with an increased risk of vascular disease in later life (table). This article summarises the emerging evidence to support this fascinating concept, notes important areas for further research, and discusses potential practical implications.