Background and aim: the aim of present systematic review and meta-analysis was determine the association between a broader array of pregnancy complications and the future risk of cardiovascular.
Method: From the electronic databases, PubMed, Cochrane Library, Embase, ISI have been used to perform a systematic literature between 2015 and 2020. Therefore, a software program (Endnote X8) has been utilized for managing the electronic titles. Searches were performed with mesh terms. Odds ratio between two groups with 95% confidence interval (CI), random effect model and restricted maximum-likelihood method were calculated. Random effects were used to deal with potential heterogeneity and I² showed heterogeneity. The Meta analysis and forest plots have been evaluated with the use of a software program Stata V16.
Result: A total of 486 potentially relevant titles and abstracts were found during the electronic and manual search. Finally, a total of 21 publications fulfilled the inclusion criteria required for this systematic review. Pooled results of nine studies examining gestational hypertension suggest a 40% (95% ICI, -0.09, and 0.90) higher risk of subsequent CVD in women with gestational hypertension compared to women without. The odds ratio was (OR, 0.40 95% CI -0.09, 0.90. P= 0.11), and heterogeneity found (I2 = 82.35%)
Conclusion: Women with a history of gestational hypertension, gestational diabetes, preterm birth, and stillbirth are at higher risk for CVD than other women.

• American College of Obstetricians and Gynecologists. (2013). Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ task force on hypertension in pregnancy. Obstetrics and gynecology, 122(5), 1122.
• Auger, N., Fraser, W. D., Schnitzer, M., Leduc, L., Healy-Profitós, J., & Paradis, G. (2017). Recurrent pre-eclampsia and subsequent cardiovascular risk. Heart, 103(3), 235-243.
• Auger, N., Potter, B. J., Bilodeau-Bertrand, M., & Paradis, G. (2018). Long-term risk of cardiovascular disease in women who have had infants with heart defects. Circulation, 137(22), 2321-2331.
• Auger, N., Potter, B. J., He, S., Healy-Profitós, J., Schnitzer, M. E., & Paradis, G. (2020). Maternal Cardiovascular Disease 3 Decades After Preterm Birth: Longitudinal Cohort Study of Pregnancy Vascular Disorders. Hypertension, 75(3), 788-795.
• Behrens, I., Basit, S., Lykke, J. A., Ranthe, M. F., Wohlfahrt, J., Bundgaard, H.,... & Boyd, H. A. (2016). Association between hypertensive disorders of pregnancy and later risk of cardiomyopathy. Jama, 315(10), 1026-1033.
• Brett, S. E., Jiang, B. Y., Turner, C., Ritter, J. M., & Chowienczyk, P. J. (2006). Elevation of plasma homocysteine by methionine loading increases the diastolic blood pressure response to exercise. Journal of hypertension, 24(10), 1985-1989.
• Brown, H. L., Warner, J. J., Gianos, E., Gulati, M., Hill, A. J., Hollier, L. M.,... & Wenger, N. K. (2018). Promoting risk identification and reduction of cardiovascular disease in women through collaboration with obstetricians and gynecologists: a presidential advisory from the American Heart Association and the American College of Obstetricians and Gynecologists. Circulation, 137(24), e843-e852.
• Brown, M. C., Best, K. E., Pearce, M. S., Waugh, J., Robson, S. C., & Bell, R. (2013). Cardiovascular disease risk in women with pre-eclampsia: systematic review and meta-analysis. European journal of epidemiology, 28(1), 1-19.
• Bulgakov, A. V., Babieva, N. S., Levanova, E. A., Gridyaeva, L. N., Erofeeva, M. A., Sokolovskaya, I. E., & Davidyan, L. Y. (2018). Specific features of psycho-emotional states of working women during pregnancy. Electronic Journal of General Medicine, 15(6), em86.
• Cain, M. A., Salemi, J. L., Tanner, J. P., Kirby, R. S., Salihu, H. M., & Louis, J. M. (2016). Pregnancy as a window to future health: maternal placental syndromes and short-term cardiovascular outcomes. American journal of obstetrics and gynecology, 215(4), 484-e1.
• Canoy, D., Cairns, B. J., Balkwill, A., Wright, F. L., Khalil, A., Beral, V.,... & Million Women Study Collaborators. (2016). Hypertension in pregnancy and risk of coronary heart disease and stroke: A prospective study in a large UK cohort. International journal of cardiology, 222, 1012-1018.
• Cheng, C. A., Lee, J. T., Lin, H. C., Lin, H. C., Chung, C. H., Lin, F. H.,... & Chiu, H. W. (2017). Pregnancy increases stroke risk up to 1 year postpartum and reduces long-term risk. QJM: An International Journal of Medicine, 110(6), 355-360.
• Cirillo, P. M., & Cohn, B. A. (2015). Pregnancy complications and cardiovascular disease death: 50-year follow-up of the Child Health and Development Studies pregnancy cohort. Circulation, 132(13), 1234-1242.
• Goueslard, K., Cottenet, J., Mariet, A. S., Giroud, M., Cottin, Y., Petit, J. M., & Quantin, C. (2016). Early cardiovascular events in women with a history of gestational diabetes mellitus. Cardiovascular diabetology, 15(1), 15.
• Grandi, S. M., Filion, K. B., Yoon, S., Ayele, H. T., Doyle, C. M., Hutcheon, J. A.,... & Platt, R. W. (2019). Cardiovascular disease-related morbidity and mortality in women with a history of pregnancy complications: systematic review and meta-analysis. Circulation, 139(8), 1069-1079.
• Grandi, S. M., Filion, K. B., Yoon, S., Ayele, H. T., Doyle, C. M., Hutcheon, J. A.,... & Platt, R. W. (2019). Cardiovascular disease-related morbidity and mortality in women with a history of pregnancy complications: systematic review and meta-analysis. Circulation, 139(8), 1069-1079.
• Grandi, S. M., Filion, K. B., Yoon, S., Ayele, H. T., Doyle, C. M., Hutcheon, J. A.,... & Platt, R. W. (2019). Cardiovascular disease-related morbidity and mortality in women with a history of pregnancy complications: systematic review and meta-analysis. Circulation, 139(8), 1069-1079.
• Grandi, S. M., Vallée‐Pouliot, K., Reynier, P., Eberg, M., Platt, R. W., Arel, R.,... & Filion, K. B. (2017). Hypertensive disorders in pregnancy and the risk of subsequent cardiovascular disease. Paediatric and Perinatal Epidemiology, 31(5), 412-421.
• Heida, K. Y., Franx, A., Van Rijn, B. B., Eijkemans, M. J., Boer, J. M., Verschuren, M. W.,... & Van Der Schouw, Y. T. (2015). Earlier age of onset of chronic hypertension and type 2 diabetes mellitus after a hypertensive disorder of pregnancy or gestational diabetes mellitus. Hypertension, 66(6), 1116-1122.
• Heida, K. Y., Velthuis, B. K., Oudijk, M. A., Reitsma, J. B., Bots, M. L., Franx, A.,... & Dutch Guideline Development Group on Cardiovascular Risk Management after Reproductive Disorders. (2016). Cardiovascular disease risk in women with a history of spontaneous preterm delivery: A systematic review and meta-analysis. European journal of preventive cardiology, 23(3), 253-263.
• Hopmans, T. E., Van Houten, C., Kasius, A., Kouznetsova, O. I., Nguyen, L. A., Rooijmans, S. V.,... & Koster, M. P. (2015). Increased risk of type II diabetes mellitus and cardiovascular disease after gestational diabetes mellitus: a systematic review.
• Hvidtjørn, D., Wu, C., Schendel, D. T. P. E. B., Thorlund Parner, E., & Brink Henriksen, T. (2016). Mortality in mothers after perinatal loss: a population‐based follow‐up study. BJOG: An International Journal of Obstetrics & Gynaecology, 123(3), 393-398.
• Kaul, P., Savu, A., Nerenberg, K. A., Donovan, L. E., Chik, C. L., Ryan, E. A., & Johnson, J. A. (2015). Impact of gestational diabetes mellitus and high maternal weight on the development of diabetes, hypertension and cardiovascular disease: a population‐level analysis. Diabetic Medicine, 32(2), 164-173.
• Kessous, R., Shoham-Vardi, I., Pariente, G., Holcberg, G., & Sheiner, E. (2013). An association between preterm delivery and long-term maternal cardiovascular morbidity. American journal of obstetrics and gynecology, 209(4), 368-e1.
• Kessous, R., Shoham-Vardi, I., Pariente, G., Sergienko, R., & Sheiner, E. (2015). Long-term maternal atherosclerotic morbidity in women with pre-eclampsia. Heart, 101(6), 442-446.
• Kessous, R., Shoham-Vardi, I., Pariente, G., Sherf, M., & Sheiner, E. (2013). An association between gestational diabetes mellitus and long-term maternal cardiovascular morbidity. Heart, 99(15), 1118-1121.
• Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P.,... & Moher, D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Journal of clinical epidemiology, 62(10), e1-e34.
• Lin, L. T., Tsui, K. H., Cheng, J. T., Cheng, J. S., Huang, W. C., Liou, W. S., & Tang, P. L. (2016). Increased risk of intracranial hemorrhage in patients with pregnancy-induced hypertension: a nationwide population-based retrospective cohort study. Medicine, 95(20).
• Løkke, A., Hilberg, O., Tønnesen, P., Ibsen, R., Kjellberg, J., & Jennum, P. (2014). Direct and indirect economic and health consequences of COPD in Denmark: a national register-based study: 1998–2010. BMJ open, 4(1).
• McDonald, E. G., Dayan, N., Pelletier, R., Eisenberg, M. J., & Pilote, L. (2016). Premature cardiovascular disease following a history of hypertensive disorder of pregnancy. International Journal of Cardiology, 219, 9-13.
• Meah, V. L., Cockcroft, J. R., Backx, K., Shave, R., & Stöhr, E. J. (2016). Cardiac output and related haemodynamics during pregnancy: a series of meta-analyses. Heart, 102(7), 518-526.
• Minissian, M. B., Kilpatrick, S., Eastwood, J. A., Robbins, W. A., Accortt, E. E., Wei, J.,... & Merz, C. N. B. (2018). Association of spontaneous preterm delivery and future maternal cardiovascular disease. Circulation, 137(8), 865-871.
• Mosca, L., Benjamin, E. J., Berra, K., Bezanson, J. L., Dolor, R. J., Lloyd-Jones, D. M.,... & Zhao, D. (2011). Effectiveness-based guidelines for the prevention of cardiovascular disease in women—2011 update: a guideline from the American Heart Association. Journal of the American College of Cardiology, 57(12), 1404-1423.
• Nelander, M., Cnattingius, S., Åkerud, H., Wikström, J., Pedersen, N. L., & Wikström, A. K. (2016). Pregnancy hypertensive disease and risk of dementia and cardiovascular disease in women aged 65 years or older: a cohort study. BMJ open, 6(1).
• Ngo, A. D., Chen, J. S., Figtree, G., Morris, J. M., & Roberts, C. L. (2015). Preterm birth and future risk of maternal cardiovascular disease–is the association independent of smoking during pregnancy?. BMC pregnancy and childbirth, 15(1), 144.
• Ngo, A. D., Roberts, C. L., Chen, J. S., & Figtree, G. (2016). Interaction of maternal smoking and preterm birth on future risk of maternal cardiovascular disease: A population-based record linkage study. European Journal of Preventive Cardiology, 23(6), 613-620.
• Peters, S. A., Yang, L., Guo, Y., Chen, Y., Bian, Z., Tian, X.,... & Chen, J. (2017). Pregnancy, pregnancy loss, and the risk of cardiovascular disease in Chinese women: findings from the China Kadoorie Biobank. BMC medicine, 15(1), 148.
• Riise, H. K. R., Sulo, G., Tell, G. S., Igland, J., Nygård, O., Vollset, S. E.,... & Daltveit, A. K. (2017). Incident coronary heart disease after preeclampsia: role of reduced fetal growth, preterm delivery, and parity. Journal of the American Heart Association, 6(3), e004158.
• Robbins, C. L., Hutchings, Y., Dietz, P. M., Kuklina, E. V., & Callaghan, W. M. (2014). History of preterm birth and subsequent cardiovascular disease: a systematic review. American journal of obstetrics and gynecology, 210(4), 285-297.
• Soh, M. C., Dib, F., Nelson-Piercy, C., Westgren, M., McCowan, L., & Pasupathy, D. (2016). Maternal-placental syndrome and future risk of accelerated cardiovascular events in Parous Swedish women with systemic lupus erythematosus—a population-based retrospective cohort study with time-to-event analysis. Rheumatology, 55(7), 1235-1242.
• Soh, M. C., Nelson‐Piercy, C., Dib, F., Westgren, M., McCowan, L., & Pasupathy, D. (2015). Brief Report: Association between pregnancy outcomes and death from cardiovascular causes in parous women with systemic lupus erythematosus: a study using Swedish population registries. Arthritis & Rheumatology, 67(9), 2376-2382.
• Tanz, L. J., Stuart, J. J., Williams, P. L., Rimm, E. B., Missmer, S. A., Rexrode, K. M.,... & Rich-Edwards, J. W. (2017). Preterm delivery and maternal cardiovascular disease in young and middle-aged adult women. Circulation, 135(6), 578-589.
• Tooher, J., Thornton, C., Makris, A., Ogle, R., Korda, A., & Hennessy, A. (2017). All hypertensive disorders of pregnancy increase the risk of future cardiovascular disease. Hypertension, 70(4), 798-803.
• Umesawa, M., & Kobashi, G. (2017). Epidemiology of hypertensive disorders in pregnancy: prevalence, risk factors, predictors and prognosis. Hypertension Research, 40(3), 213-220.
• Yamada, K., Iso, H., Cui, R., & Tamakoshi, A. (2017). Recurrent pregnancy loss and cardiovascular disease mortality in Japanese women: a population-based, prospective cohort study. Journal of Stroke and Cerebrovascular Diseases, 26(5), 1047-1054.

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