This thesis of Renée Burger investigates long-term health implications of pregnancy disorders for the mother and the child.
Part I focusses on the link between pregnancy and maternal cardiovascular health. Burger and colleagues show in this thesis that women, irrespective of ethnicity, are at increased risk of cardiovascular disease after a complicated pregnancy. They find that, despite pregnancy complications being a clear risk factor for cardiovascular disease, adding it as criterium for formal cardiovascular disease risk screening does not aid in the identification of those at risk. Nevertheless, they argue that pregnancy disorders offer a window of opportunity to identify this increased risk early in life and to modify it in order to reduce the burden of cardiovascular disease later in life. To do so, better tools to predict both pregnancy disorders and cardiovascular disease after pregnancy, and better screening and intervention strategies aimed at risk reduction are needed.
Part II of the thesis studies cognitive development of children in relation to pregnancy complications, interventions around birth and sociodemographic characteristics during pregnancy. They find that being born prematurely, having low birthweight for gestational age, low socio-economic status or being born after labour induction is associated with slightly reduced average school performance at age 12. They emphasize the need to incorporate long-term outcomes in future research, and to appropriately weigh short- and long-term risks in decisions around timing of labour and other interventions.
