Pre-eclampsia and future cardiovascular risk factors

• Autor(a) principal: Alexandra Santos Monge da Costa Duarte
• Data de Publicação: 2023
• Tipo de documento: Dissertação
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://hdl.handle.net/10216/150288
• topic: Medicina clínica; Clinical medicine

Introduction: Pre-eclampsia is one of the hypertensive disorders of pregnancy and it is associated with maternal complications that seem to remain after pregnancy. This systematic review aimed to evaluate the association between pre-eclampsia and future cardiovascular risk factors. Methods: We performed a systematic review guided by the Systematic Reviews and Meta-Analyses guidelines. The search was performed on PubMed, Web of Science and Cochrane Library. During the research, we selected articles that had preeclampsia as exposure. The cardiovascular risk factors considered as outcomes were hypertension, dyslipidemia, metabolic syndrome, and diabetes mellitus. From the selected articles, information regarding the year of publication, country/region, type of study, time of follow-up, inclusion criteria, results and conclusions were extracted and summarized. From these studies, the risk of bias was measured using the NIH Study Quality Assessment Tool, NIH quality assessment tool for case-control studies and NIH quality assessment tool for observational cohort and cross-sectional studies. Results: In this systematic review with 13 articles, we obtained a total of 2,201 women with pre-eclampsia and 8,559 controls. The studies published from 2005 to 2020 covered several geographical regions including Europe, Asia, Oceania, South America, and North America. The follow-up time ranges from 6 months to 25 years postpartum. Four were case-control studies, seven cohort studies and two cross sectional studies. All the studies that evaluated hypertension as an outcome demonstrated a statistically significant relationship between preeclampsia and a higher risk of hypertension in the future. From the five studies evaluating metabolic syndrome, four of them established a statistically significant association between pre-eclampsia and metabolic syndrome. Five studies evaluated the relationship between pre-eclampsia and a higher prevalence of diabetes mellitus in the future and in none of the studies were found this relationship. Four articles presenting dyslipidemia as an outcome and only one demonstrated a statistically significant relationship between pre-eclampsia and future risk of dyslipidemia. Discussion: In this systematic review, including 10,769 women, we demonstrated that there is an association between preeclampsia and future cardiovascular risk factors. There were some limitations in this study such as restriction of the studies to those in Portuguese and in English. Also, there were differences in some criteria established by each study when defining outcomes and only seven of the 13 studies adjusted for potential confounding variables.