Association of pre-eclampsia with metabolic syndrome and increased risk of cardiovascular disease in women: A systemic review

Background and Objectives: Cardiovascular disease (CVD) is the leading cause of death in women globally. Preeclampsia has been linked to increased risk of developing heart disease later in life. The best approach for the prevention of CVD after preeclampsia is yet unclear. Studies assessing CVD risk post preeclampsia have included metabolic risk factors that define the metabolic syndrome (MS). This review quantifies the association between preeclampsia and CVD in the context of metabolic risk factors that define the MS. Materials and Methods: PubMed database was searched for relevant articles from 1999 to March 2015. The search phrase was "preeclampsia and MS." After two levels of screening by title and abstract, case-control, cohort, and cross-sectional studies that included at least 50 subjects were selected. Results: Twenty-four articles that reported the prevalence or odds for MS and its components following a history of preeclampsia and the prevalence of preeclampsia in women with prepregnancy MS were selected. A total of 9 case-control, 11 cohort, and four cross-sectional studies were included. The prevalence of MS ranged from 10.9% to 27.3% after a preeclamptic pregnancy. About 88% of the case-control studies showed a statistically significant difference in prevalence of MS post preeclampsia whereas 75% of the cohort studies reported prevalence values >10% for the prevalence of MS post preeclampsia. The odds for developing MS post preeclampsia ranged from 1.23 to 3.60 and 83% of the studies reported an odds ratio >2. The prevalence of developing preeclampsia in women with prepregnancy MS ranged from 26.7% to 45% compared to 4.7% to 17% among controls. Conclusion: The prevalence and odds for developing MS after a preeclamptic pregnancy are high suggesting that MS may be involved in the pathogenesis of CVD following preeclampsia. This will provide evidence on the potential health benefits of a modifiable CVD risk screening program for women with a history of preeclampsia.