悪質な妊娠の転帰と母体の健康：長期的な利益のために必要なアクション

Adverse pregnancy outcomes and maternal health: action needed for long-term benefit.

• Peter M Barrett
• Ali S Khashan
• Fergus P McCarthy
• Karolina Kublickiene

抄録

近年、妊娠中の合併症が後世の慢性疾患と関連していることを示す質の高いエビデンスが蓄積されてきています。妊娠は、将来の心血管疾患（CVD）や慢性腎臓病（CKD）の基礎となるリスクを明らかにする代謝の「ストレステスト」と考えられています。しかし、この情報を長期的な心腎リスクの低減に利用できる可能性は、まだ十分には実現されていません。妊娠高血圧障害、妊娠糖尿病、早産、子宮内発育制限、妊娠消失の既往歴のある女性は、妊娠が合併症を伴わなかった女性と比較して、CVD、脳血管疾患、早死に至るリスクが高い。

In recent years, high-quality evidence has been accumulating that pregnancy complications are linked to a range of chronic diseases in later life. Pregnancy is regarded as a metabolic "stress test" which may unmask women's underlying risk of future cardiovascular disease (CVD) or chronic kidney disease (CKD). However, the potential for this information to be used in long-term cardio-renal risk reduction has not been fully realised. Women who have a history of hypertensive disorders of pregnancy, gestational diabetes, preterm delivery, intra-uterine growth restriction, or pregnancy loss are at higher risk of CVD, cerebrovascular disease, and premature mortality relative to those whose pregnancies were uncomplicated.

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