title: Cardiovascular risk management after reproductive and pregnancy-related disorders: A Dutch multidisciplinary evidence-based guideline.
abstract: In the past decades evidence has accumulated that women with reproductive and pregnancy-related disorders are at increased risk of developing cardiovascular disease (CVD) in the future. Up to now there is no standardised follow-up of these women becausee guidelines on cardiovascular risk management for this group are lacking. However, early identification of high-risk populations followed by prevention and treatment of CVD risk factors has the potential to reduce CVD incidence. Therefore, the Dutch Society of Obstetrics and Gynaecology initiated a multidisciplinary working group to develop a guideline for cardiovascular risk management after reproductive and pregnancy-related disorders.
  
  
  
  The guideline addresses the cardiovascular risk consequences of gestational hypertension, preeclampsia, preterm delivery, small-for-gestational-age infant, recurrent miscarriage, polycystic ovary syndrome and premature ovarian insufficiency. The best available evidence on these topics was captured by systematic review. Recommendations for clinical practice were formulated based on the evidence and consensus of expert opinion. The Dutch societies of gynaecologists, cardiologists, vascular internists, radiologists and general practitioners reviewed the guideline to ensure support for implementation in clinical practice.
  
  
  
  For all reproductive and pregnancy-related disorders a moderate increased relative risk was found for overall CVD, except for preeclampsia (relative risk 2.15, 95% confidence interval 1.76-2.61).
  
  
  
  Based on the current available evidence, follow-up is only recommended for women with a history of preeclampsia. For all reproductive and pregnancy-related disorders optimisation of modifiable cardiovascular risk factors is recommended to reduce the risk of future CVD.
authors.affiliation: Division of Woman and Baby, University Medical Center Utrecht, The Netherlands.|Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands.
authors.forename: Karst Y
authors.initials: KY
authors.lastname: Heida
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands.
authors.forename: Michiel L
authors.initials: ML
authors.lastname: Bots
authors.affiliation: Department of Obstetrics and Gynaecology, VU University, The Netherlands.
authors.forename: Christianne Jm
authors.initials: CJ
authors.lastname: de Groot
authors.affiliation: Department of Obstetrics and Gynaecology, Medical Center Haaglanden, The Netherlands.
authors.forename: Frederique M
authors.initials: FM
authors.lastname: van Dunné
authors.affiliation: Division of Woman and Baby, University Medical Center Utrecht, The Netherlands.
authors.forename: Nurah M
authors.initials: NM
authors.lastname: Hammoud
authors.affiliation: Department of Obstetrics and Gynaecology, University of Groningen, The Netherlands.
authors.forename: Annemiek
authors.initials: A
authors.lastname: Hoek
authors.affiliation: Department of Obstetrics and Gynecology, Erasmus MC University Medical Center, The Netherlands.
authors.forename: Joop Se
authors.initials: JS
authors.lastname: Laven
authors.affiliation: Department of Cardiology, Radboud University Medical Center, The Netherlands.
authors.forename: Angela Hem
authors.initials: AH
authors.lastname: Maas
authors.affiliation: Department of Internal Medicine, Erasmus MC, The Netherlands.
authors.forename: Jeanine E
authors.initials: JE
authors.lastname: Roeters van Lennep
authors.affiliation: Department of Radiology, University Medical Center Utrecht, The Netherlands.
authors.forename: Birgitta K
authors.initials: BK
authors.lastname: Velthuis
authors.affiliation: Division of Woman and Baby, University Medical Center Utrecht, The Netherlands a.franx-2@umcutrecht.nl.
authors.forename: Arie
authors.initials: A
authors.lastname: Franx
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000517:prevention & control; D019317:Evidence-Based Medicine; D005260:Female; D005544:Forecasting; D014943:Global Health; D006801:Humans; D015994:Incidence; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology*; D012307:Risk Factors; D012308:Risk Management / Q000379:methods*
keywords: Pregnancy; cardiovascular disease; polycystic ovary syndrome; preeclampsia; premature ovarian insufficiency; preterm delivery; prevention; recurrent miscarriage; risk assessment; small-for-gestational-age