WHA 74 Pillar 1 – Agenda item grouping 1

Agenda Item: Agenda item 13.2, Agenda item 13.3 and Agenda item 13.9 FIGO Speaker: Dr Jeanne Conry

The International Federation of Gynecology and Obstetrics strongly supports the global action plan for the prevention and control of non-communicable diseases (NCDs). NCDs have been the leading cause of death among women for more than 30 years – over 60% of deaths each year, particularly in low- and middle-income countries.

One in three women will die from CVD, and clinicians are less likely to predict and recognise CVD in women. Recognition, risk stratification and long-term prevention strategies are important steps to prevent premature death from CVD.

For women, pregnancy is often considered the “window” to their future health, because six well-recognised pregnancy complications or occurrences predict long-term risk of cardiovascular disease (CVD).

What are these risks?

  • Parity exceeding five offspring increases cardiovascular risk fivefold.
  • For the 8% of deliveries associated with low birth weight (<2500 g) there is a two-fold increase in cardiovascular disease and death.
  • Preterm deliveries are associated with a 1.2–3-fold risk of CVD, even in normotensive deliveries.
  • Gestational diabetes – associated with upwards of 10% of pregnancies – is associated with a seven-fold lifelong risk of diabetes and concomitant risk of CVD.
  • Hypertension in pregnancy results in a four-fold risk of hypertension later in life, and two-fold risk of thromboembolic diseases.
  • Obesity in pregnancy is associated with up to a four-fold lifelong risk of diabetes, hypertension, CVD and death.

Pregnancy can be considered a physiologic “treadmill test” because 80–90% of women conceive at some time, and 30–40% of women have at least one risk factor from pregnancy that can lead to long-term health problems. Therefore, about 30% of women have a predictor of long-term CVD. Using pregnancy to identify risk and creating lifelong prevention strategies is an effective approach to improving women’s health – and the best preventive medicine we have.