# Adverse zwangerschapsuitkomsten signaleren levenslang hart- en vaatziektenrisico

*geplaatst 2026-09-09 · Nierziekte · European heart journal · doi 10.1093/eurheartj/ehag654 · https://hartvaat.nl/2026/09/01/adverse-zwangerschapsuitkomsten-signaleren-levenslang-hart-en-vaatziektenrisico/*

Een overzichtsstudie in het European Heart Journal benadrukt dat adverse zwangerschapsuitkomsten zoals pre-eclampsie, zwangerschapsdiabetes en premature bevalling niet alleen obstetrische gebeurtenissen zijn, maar vroege indicatoren van onderliggende cardiometabale dysfunctie. Vrouwen met deze complicaties hebben een significant verhoogd risico op latere hart- en vaatziekten, nierfalen en vroegtijdige cardiovasculaire sterfte, mede door aanhoudende endotheeldysfunctie en metabole afwijkingen. Voor de klinische praktijk betekent dit dat het puerperium een cruciaal preventief venster is: systematische bloeddruk- en metabole screening, gecombineerd met een soepele overgang naar de huisarts, kan de lange termijnrisico’s aanzienlijk verminderen.

## English: Adverse pregnancy outcomes and long-term cardiovascular risk: lifelong connections.

A narrative review in the European Heart Journal highlights that adverse pregnancy outcomes, including hypertensive disorders, gestational diabetes, and preterm birth, serve as early markers of underlying cardiometabolic dysfunction rather than isolated obstetric events. Women with these complications face a significantly elevated long-term risk of coronary artery disease, heart failure, chronic kidney disease, and premature cardiovascular mortality, driven by persistent endothelial and metabolic abnormalities. Clinically, this underscores the postpartum period as a critical preventive window where systematic blood pressure and metabolic screening, alongside structured transition to primary care, can substantially mitigate lifelong cardiovascular risk.

## Abstract (original, from the publication)

Pregnancy represents a critical period during which the maternal cardiovascular system adapts to profound haemodynamic and metabolic demands. When these adaptive mechanisms are impaired, adverse pregnancy outcomes (APOs)-including hypertensive disorders of pregnancy, gestational diabetes, pre-term birth, small-for-gestational-age birth, and pregnancy loss-occur. Extensive epidemiological evidence demonstrates that APOs are not isolated obstetric events but early clinical markers of cardiometabolic dysfunction that identify women at increased risk of coronary artery disease, heart failure, stroke, chronic kidney disease, and premature cardiovascular mortality. Shared mechanisms include endothelial dysfunction, inflammation, and insulin resistance, establishing a continuum between obstetric complications and later cardiovascular disease. Early post-partum studies reveal persistent hypertension, adverse cardiac remodelling, and metabolic abnormalities that mediate much of the long-term excess cardiovascular risk. These findings redefine the 'fourth trimester' as a preventive window in which timely blood pressure surveillance, metabolic screening, and lifestyle optimization can yield durable cardiovascular benefit. Integrated cardio-obstetric care models, digital follow-up, and systematic transition to primary care are crucial for maintaining long-term prevention. Addressing persistent gaps in limited provider awareness, fragmented follow-up, and disparities across socially disadvantaged populations remains critical. Recognizing pregnancy complications as indicators of underlying cardiovascular vulnerability offers an opportunity to shift prevention upstream and promote lifelong cardiovascular health for women.

Auteurs: Veronica Giorgione, Nisha I Parikh, Daniela Pedicino, Basky Thilaganathan

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Bron: European heart journal, https://doi.org/10.1093/eurheartj/ehag654. Bijgewerkt 2026-09-02T01:26:46Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.