In 2011, the American Heart Association added preeclampsia, gestational diabetes mellitus (GDM), and delivery of a growth-restricted child as pregnancy-related risk factors for cardiovascular disease (CVD).1 This move was applauded by the obstetric research community, which for some years had emphasized the importance of pregnancy as a stress test for detecting women at excessive risk for premature CVD.2–4

CVD is the leading cause of death for men and women in high-income and most low-to-middle–income countries.5 Globally, coronary artery disease kills more women than men,6 although women develop CVD 10 to 15 years later than men. Women frequently present with unrecognized CVD symptoms and are twice as likely as men to die of a first acute myocardial infarction if <50 years old.7 The preclinical stages of CVD are evident from a young age and are modifiable through control of classic risk factors (insulin resistance/diabetes mellitus, obesity, lack of exercise, tobacco smoking, hypertension, and hyperlipidemia).8,9 In this regard, pregnancy is a window of opportunity for identifying those women with perinatal complications who may benefit from early risk detection and early CVD prevention.

In this article, we summarize the associations between pregnancy, placenta-related pregnancy complications, and future maternal CVD. We present established as well as more novel hypotheses, which may explain these epidemiological associations. The interventions that potentially could reduce risks of future CVD are enumerated. To facilitate progress, we suggest methods of harmonizing study designs, long-term follow-ups of pregnancy cohorts and biobanks, and pooling of the world’s data in ways that can enhance the power of current and future research.

### Preeclampsia and Fetal Growth Restriction and Future CVD Risk

Preeclampsia is a pregnancy-specific multisystem disorder defined by new-onset hypertension and proteinuria after gestational week 20, or new onset preeclampsia-associated signs in the absence of proteinuria.8 Preeclampsia requires the presence of …

Pregnancy and Long-Term Maternal Cardiovascular Health: Progress Through Harmonization of Research Cohorts and Biobanks

Circulating Tissue Factor Pathway Inhibitor (TFPI) is increased preceding preeclampsia diagnosis and in established preeclampsia

Introduction: Preeclampsia is emergencies in obstetrics, where pregnant women experience health conditions that can be life-threatening and can occur during pregnancy, natal and post-natal. If this obstetric emergency is not treated immediately, it can result in death the mother and also the fetus. Understanding care needs of pregnant with preeclampsia is very important for families because most pregnant women and their families lack understanding and information about high-risk pregnancy care for this disease. Objectives: This research aims to explore the needs of families in the care of preeclampsia. Methods: This research used qualitative descriptive to obtain answers related to individual opinions, responses and perceptions with exploring family needs for care pregnant with preeclampsia. Results: The results of this research there are seven themes related to family needs in pregnancy care with preeclampsia, namely: 1) Description of family knowledge about pregnant with preeclampsia, 2) Information needs, 3) Comfort needs, 4) Economic / financial needs, 5) Spiritual needs, 6) Needs for support from other family members, 7) Need for support from health workers. Conclusions: The importance of involvement of the family and surrounding environment, as a source of strength for pregnant with preeclampsia allows better care for mothers, their babies and reduces the consequences of advanced preeclampsia. Health workers are expected to be able to involve families in the care of pregnant women with preeclampsia as a promotional, preventive and curative effort. 1) Description of family knowledge about pregnant with preeclampsia, 2) Information needs, 3) Comfort needs, 4) Economic / financial needs, 5) Spiritual needs, 6) Needs for support from other family members, 7) Need for support from health workers. Conclusions: The importance of involvement of the family and surrounding environment, as a source of strength for pregnant with preeclampsia allows better care for mothers, their babies and reduces the consequences of advanced preeclampsia. Health workers are expected to be able to involve families in the care of pregnant women with preeclampsia as a promotional, preventive and curative effort. 1) Description of family knowledge about pregnant with preeclampsia, 2) Information needs, 3) Comfort needs, 4) Economic / financial needs, 5) Spiritual needs, 6) Needs for support from other family members, 7) Need for support from health workers. Conclusions: The importance of involvement of the family and surrounding environment, as a source of strength for pregnant with preeclampsia allows better care for mothers, their babies and reduces the consequences of advanced preeclampsia. Health workers are expected to be able to involve families in the care of pregnant women with preeclampsia as a promotional, preventive and curative effort.

/pdf/family-support-related-to-information-comfort-economy-and-qbtenhr3ql.pdf

Family Support Related to Information, Comfort, Economy and Spiritual in Preeclamptic Pregnancy Care: Qualitative Exploration

INTRODUCTION
Risk evaluation for preeclampsia in early pregnancy allows identification of women at high risk. Prediction models for preeclampsia often include circulating concentrations of placental growth factor (PlGF); however, the models are usually limited to a specific PlGF method of analysis. The aim of this study was to compare three different PlGF methods of analysis in a Swedish cohort to assess their convergent validity and appropriateness for use in preeclampsia risk prediction models in the first trimester of pregnancy.


MATERIAL AND METHODS
First-trimester blood samples were collected in gestational week 11+0 to 13+6 from 150 pregnant women at Uppsala University Hospital during November 2018 until November 2020. These samples were analyzed using the different PlGF methods from Perkin Elmer, Roche Diagnostics, and Thermo Fisher Scientific.


RESULTS
There were strong correlations between the PlGF results obtained with the three methods, but the slopes of the correlations clearly differed from 1.0: PlGFPerkinElmer  = 0.553 (95% confidence interval [CI] 0.518-0.588) * PlGFRoche -1.112 (95% CI -2.773 to 0.550); r = 0.966, mean difference -24.6 (95% CI -26.4 to -22.8). PlGFPerkinElmer  = 0.673 (95% CI 0.618-0.729) * PlGFThermoFisher -0.199 (95% CI -2.292 to 1.894); r = 0.945, mean difference -13.8 (95% CI -15.1 to -12.6). PlGFRoche  = 1.809 (95% CI 1.694-1.923) * PlGFPerkinElmer +2.010 (95% CI -0.877 to 4.897); r = 0.966, mean difference 24.6 (95% CI 22.8-26.4). PlGFRoche  = 1.237 (95% CI 1.113-1.361) * PlGFThermoFisher +0.840 (95% CI -3.684 to 5.363); r = 0.937, mean difference 10.8 (95% CI 9.4-12.1). PlGFThermoFisher  = 1.485 (95% CI 1.363-1.607) * PlGFPerkinElmer +0.296 (95% CI -2.784 to 3.375); r = 0.945, mean difference 13.8 (95% CI 12.6-15.1). PlGFThermoFisher  = 0.808 (95% CI 0.726-0.891) * PlGFRoche -0.679 (95% CI -4.456 to 3.099); r = 0.937, mean difference -10.8 (95% CI -12.1 to -9.4).


CONCLUSION
The three PlGF methods have different calibrations. This is most likely due to the lack of an internationally accepted reference material for PlGF. Despite different calibrations, the Deming regression analysis indicated good agreement between the three methods, which suggests that results from one method may be converted to the others and hence used in first-trimester prediction models for preeclampsia.

https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/aogs.14615

Comparing the results from a Swedish pregnancy cohort using data from three automated placental growth factor immunoassay platforms intended for first-trimester preeclampsia prediction.

The rapid expansion of sophisticated molecular biomarker data information for detecting early biological responses to chemical agents in concert with the evolution of personalized medicine databases raises a number of challenging issues for the future with regard to how to most effectively make use of this growing body of personal information for constructive public health purposes and yet protect the privacy of the individual. As discussed elsewhere in this book, the growing body of complex biomarker data require appropriate statistical analysis, reasoned digestion, and translation into terminology that is readily understood by persons with limited technical backgrounds. This chapter will attempt to address the need for translation of technical biomarker information on two levels. The first is to provide some hopefully useful insights into how currently available “omic” biomarker data could be used for risk assessment purposes in the next 10 years. The second is to consider how the merger of biomarker data with the personalized electronic medical records of individuals could be used to aid preventable chemical-induced diseases while protecting the privacy of the individuals. These are complex but achievable issues.

Technical Translational Analysis of Molecular Biomarker Data

Maternal circulating PlGF concentrations and placenta-related pregnancy complications: First results from the CoLab AngF Study.

[94-OR]: Extending the scope of individual patient data meta-analyses: Merging algorithms for biomarker measurements from heterogeneous laboratory platforms. The CoLAB Preeclampsia angiogenic factor study.

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Maternal circulating PlGF concentrations and placenta-related pregnancy complications: First results from the CoLab AngF Study.

[94-OR]: Extending the scope of individual patient data meta-analyses: Merging algorithms for biomarker measurements from heterogeneous laboratory platforms. The CoLAB Preeclampsia angiogenic factor study.