Pregnancy Outcomes, An Indicator of Long Term Health

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George Saade, President of the Society for Maternal-Fetal Medicine in Texas shared that “A woman’s pregnancy outcome can be an indicator of future health conditions.” Saade presented to the members of SMFM convincing reasons and scientific evidences that link a woman’s long term health to her pregnancy outcomes. At the conclusion of his presentation, he emphasized the importance of collaboration between physicians in reviewing the health records of patients more particularly in underscoring the pregnancy outcome of women knowing that these can be important in determining health outcomes.

According to Saade, there have been multiple studies linking hypertensive disorders during pregnancy or PIH (pregnancy induced hypertension) and long term health outcomes. One study involved 15,065 women in Norway whose medical records were analyzed against their health outcomes. “Hypertensive disorders in pregnancy and subsequently measured cardiovascular risk factors” (Magnussen EB, Vatten LJ, Smith GD, Romundstad PR; Obstet Gynecol 2009), provides incontrovertible evidence that women with pregnancy-related hypertension are at higher risk for hypertension and metabolic abnormalities later in life. He also mentioned that other researches have pointed out preterm delivery, stillbirths, and restriction or abnormalities of fetal growth are correlated with long term maternal cardiovascular and metabolic disorders which may include insulin resistance and Insulin-Dependent Diabetes Mellitus.

Said Saade, “Pregnancy represents a unique opportunity to identify women who may be at increased risk of chronic diseases later in life. For patients with pregnancy complications, the care should not stop at delivery or shortly thereafter. It may be time to change the paradigm from short term prenatal care to maternal care. It would be appropriate for the obstetrician to identify mothers who may be at risk for long term diseases to ensure that these women receive the preventive care needed starting in the postpartum period rather than waiting until they reach the age for routine check-ups in the general population.”

The study have found out that weight gain during pregnancy is a vital factor that determines long term health outcomes. Furthermore, the study showed that failure to cut down one’s weight after delivery is linked with long term obesity, as well as its consequences. According to the findings, the postpartum period is an important opportunity to promote healthy lifestyle for the postpartum woman. One of the strategies is exercise, balanced diet and breastfeeding, more importantly. Breastfeeding can aid the woman to return to her pre-pregnant weight and improve her metabolism.

Saade explained that “One of the limitations is that pregnancy complications are not always on the mind of general practitioners when they are caring for a woman later in life. It would be very advantageous for all physicians who see female patients to review their patients’ pregnancy history.” Essential measures may also be taken like regular follow up check ups with the physician and having routine lipid and glucose tolerance tests.

However, Saade disclaimed that not all women who had difficult pregnancies will have cardiovascular and metabolic diseases later in life. He further shared that, “This information puts obstetricians in a position of holding a primary role in the prevention of chronic diseases by identifying women at the greatest risk. We have the opportunity to successfully identify markers that will impact our patients for the remainder of their lives. No longer is our role confined to a single condition – a single pregnancy. We now have the capability and resources to identify and prevent chronic diseases in mothers and their offspring.”

 

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