Other adverse pregnancy outcomes and future chronic disease

Cardiovascular disease is the leading cause of morbidity and mortality in females worldwide. Pregnancy is associated with significant physiologic changes that may function as a natural stress test to detect women at future risk. It is established that women who have had a pregnancy complicated by gestational diabetes or a hypertensive disorder of pregnancy are at increased risk of cardiovascular disease later in life, and there is growing evidence that women who deliver infants preterm or growth-restricted infants have an elevated risk as well. Consideration should be given to including these outcomes as indicators of cardiovascular risk. Pregnancy represents a teachable moment when it would be ideal to identify women at risk. Improved integration of women's primary health care and an enhanced knowledge base on the part of clinicians will be necessary to fully incorporate these findings into the clinical care of women.