Pregnancy: a stress test for life

Curr Opin Obstet Gynecol. 2003 Dec;15(6):465-71. doi: 10.1097/00001703-200312000-00002.


Purpose of review: This review describes how the physiological demands of pregnancy act as a maternal stress test that can predict a woman's health in later life. Pregnancy transiently catapults a woman into a metabolic syndrome that predisposes to vascular endothelial dysfunction. Women who are already predisposed to this phenotype develop gestational hypertension or diabetes mellitus, which re-emerge in later life as the metabolic syndrome returns. Pregnancy can also temporarily unmask sub-clinical disease, which may return in later life when the effects of ageing diminish the limited reserves of a vulnerable organ.

Recent findings: Recent studies have attempted to assess how gestational syndromes affect the risk for a woman of developing a diverse range of diseases in later life. As well as cardiovascular disease and diabetes mellitus, pregnancy can reveal a vulnerability to thyroid and pituitary disorders, liver and renal disease, depression, thrombosis and even cancer.

Summary: Although our knowledge of this phenomenon is incomplete, women who have had gestational syndromes, in particular pregnancy-induced hypertension/preeclampsia or gestational diabetes, should make lifestyle changes that will reduce their risk of cardiovascular disease in later life.

Publication types

  • Review

MeSH terms

  • Age Factors
  • Aging / physiology*
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / physiopathology
  • Disease / etiology*
  • Female
  • Humans
  • Pregnancy / physiology*
  • Pregnancy Complications*
  • Stress, Physiological / complications
  • Stress, Physiological / physiopathology*