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  • Review Article
  • Special Issue: Current evidence and perspectives for hypertension management in Asia
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Postpartum and interpregnancy care of women with a history of hypertensive disorders of pregnancy

Hypertension Research (2024)Cite this article

Abstract

Hypertensive disorders of pregnancy (HDP) are common complications associated with maternal and neonatal morbidity and mortality worldwide. Insights gained from long-term cohort studies have revealed that women with a history of HDP are predisposed to recurrent HDP in subsequent pregnancies and face heightened risks for cardiovascular and metabolic diseases later in life. Pregnancy is a unique condition that overloads maternal cardiac and metabolic functions, and is recognized as a “maternal stress test” for future cardiovascular and metabolic diseases. Pregnancy and postpartum period provide a valuable opportunity for identifying women with underlying and unrecognized cardiovascular and metabolic risk factors. Establishing an effective postpartum healthcare program for women who have experienced HDP is crucial in reducing the future risk of health complications. Postpartum care consists of supportive care for both mothers and children, including not only the assessment of physical and psychological well-being but also long-term postpartum preventive health management. Interpregnancy care is a continuum from postpartum care and includes supportive care to prepare for future pregnancies. Various initiatives across nations have been initiated to establish follow-up programs for women with a history of HDP; however, sufficient evidence of the impact of such programs is not available. Substantial challenges persist in establishing an efficient postpartum follow-up program, including educational strategies, selection of effective lifestyle interventions, and collaboration among various healthcare providers. This review outlines the postpartum and interpregnancy care of women who have experienced HDP as well as the current status and challenges of related healthcare initiatives in Japan.

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Fig. 1: Postpartum and interpregnancy care within the continuum of women’s lifetime care.
Fig. 2: Mechanisms underlying increased risk for cardiovascular disease in women with a history of hypertensive disorders of pregnancy.
Fig. 3: Effects of interpregnancy and postpartum care on reduction of recurrent hypertensive disorders of pregnancy and future cardiovascular disease.
Fig. 4: Strategies for improving pregnancy outcomes in subsequent pregnancies and risk reduction of future cardiovascular and metabolic diseases in women with a history of HDP.

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Acknowledgements

The authors thank Editage (www.editage.jp) for the English language editing.

Funding

This study was supported by grants awarded to TU by the Japan Society for the Promotion of Science (JSPS KAKENHI 22K16857) and Yamaguchi Endocrine Research Foundation.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan

    Takafumi Ushida, Sho Tano, Kenji Imai, Seiko Matsuo, Hiroaki Kajiyama & Tomomi Kotani

  2. Division of Reproduction and Perinatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan

    Takafumi Ushida, Sho Tano, Kenji Imai, Seiko Matsuo & Tomomi Kotani

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  1. Takafumi Ushida
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Ushida, T., Tano, S., Imai, K. et al. Postpartum and interpregnancy care of women with a history of hypertensive disorders of pregnancy. Hypertens Res (2024). https://doi.org/10.1038/s41440-024-01641-7

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