Lipoprotein metabolism and vascular complications in pregnancy

Future Lipidology

Volumn 4, Issue 1, 2009, Pages 91-102

  Huda, Shahzya S ^a   Sattar, Naveed ^a   Freeman, Dilys J ^a  

^a UNIVERSITY OF GLASGOW   (United Kingdom)

Author keywords

Adipocyte lipolysis; Cardiovascular disease; Free fatty acids; Gestational diabetes mellitus; Lipid metabolism; Obesity; Pre eclampsia; Pregnancy; Triglyceride

Indexed keywords

ABC TRANSPORTER G1; FATTY ACID; PEROXISOME PROLIFERATOR ACTIVATED RECEPTOR GAMMA; TRIACYLGLYCEROL; VASCULAR CELL ADHESION MOLECULE 1; VERY LOW DENSITY LIPOPROTEIN CHOLESTEROL;

BODY COMPOSITION; CARBOHYDRATE METABOLISM; CARDIOVASCULAR DISEASE; CARDIOVASCULAR RISK; CATABOLISM; CATECHOLAMINE RELEASE; CHOLESTEROL BLOOD LEVEL; FATTY ACID BLOOD LEVEL; FIRST TRIMESTER PREGNANCY; GLUCOSE TOLERANCE TEST; HORMONE SENSITIVITY; HUMAN; INSULIN RESISTANCE; INSULIN SENSITIVITY; LIPID METABOLISM; LIPID STORAGE; LIPOLYSIS; LIPOPROTEIN METABOLISM; METABOLIC STRESS; OBESITY; PATHOGENESIS; PLACENTAL TRANSFER; PREECLAMPSIA; PREGNANCY; PREGNANCY DIABETES MELLITUS; PRIORITY JOURNAL; PROTEIN EXPRESSION; REVIEW; THIRD TRIMESTER PREGNANCY; TRIACYLGLYCEROL BLOOD LEVEL; VASCULAR DISEASE;

EID: 67149146312     PISSN: 17460875     EISSN: None     Source Type: Journal    
DOI: 10.2217/17584299.4.1.91     Document Type: Review

References (100)

1. Villar J, Cogswell M, Kestler E, Castillo P, Menendez R, Repke JT: Effect of fat and fat-free mass deposition during pregnancy on birth weight. Am. J. Obstet. Gynecol. 167(5), 1344-1352 (1992).
2. Douglas AJ, Johnstone LE, Leng G: Neuroendocrine mechanisms of change in food intake during pregnancy: a potential role for brain oxytocin. Physiol. Behav. 91 (4), 352-365 (2007).
3. Ramos MP, Crespo-Solans MD, del Campo S, Cacho J, Herrera E: Fat accumulation in the rat during early pregnancy is modulated by enhanced insulin responsiveness. Am. J. Physiol. Endocrinol. Metab. 285 (2), E318-E328 (2003).
4. Catalano PM, Tyzbir ED, Roman NM, Amini SB, Sims EA: Longitudinal changes in insulin release and insulin resistance in nonobese pregnant women. Am. J. Obstet. Gynecol. 165(6 Pt 1), 1667-1672 (1991).
5. Ryan EA, Enns L: Role of gestational hormones in the induction of insulin resistance. J. Clin. Endocrinol. Metab. 67(2), 341-347 (1988).
6. Diderholm B, Stridsberg M, Ewald U, Lindeberg-Norden S, Gustafsson J: Increased lipolysis in non-obese pregnant women studied in the third trimester. BJOG 112(6), 713-718 (2005).
7. Catalano PM, Roman-Drago NM, Amini SB, Sims EA: Longitudinal changes in body composition and energy balance in lean women with normal and abnormal glucose tolerance during pregnancy. Am. J. Obstet. Gynecol. 179(1), 156-165 (1998).
8. Martin-Hidalgo A, Holm C, Belfrage P, Schotz MC, Herrera E: Lipoprotein lipase and hormone sensitive lipase activity and mRNA in rat adipose tissue during pregnancy. Am. J. Physiol. 266(6 Pt 1), E930-E935 (1994).
9. Herrera EM, Knopp RH, Freinkel N: Urinary excretion of epinephrine and norepinephrine during fasting in late pregnancy in the rat. Endocrinology 84 (2), 447-450 (1969).
10. Sivan E, Homko CJ, Chen X, Reece EA, Boden G: Effect of insulin on fat metabolism during and after normal pregnancy. Diabetes 48(4), 834-838 (1999).
11. Catalano PM, Nizielski SE, Shao J, Preston L, Qiao L, Friedman JE: Downregulated IRS-1 and PPARγ in obese women with gestational diabetes: relationship to FFA during pregnancy. Am. J. Physiol. Endocrinol. Metab. 282(3), E522-E533 (2002).
12. Freinkel N: Banting Lecture 1980. Of pregnancy and progeny. Diabetes 29(12), 1023-1035 (1980).
13. Zorzano A, Herrera E: Comparative utilization of glycerol and alanine as liver gluconeogenic substrates in the fed late pregnant rat. Int. J. Biochem. 18(7), 583-587 (1986).
14. Herrera E, Knopp RH, Freinkel N: Carbohydrate metabolism in pregnancy. VI. Plasma fuels, insulin, liver composition, gluconeogenesis, and nitrogen metabolism during late gestation in the fed and fasted rat. J. Clin. Invest. 48(12), 2260-2272 (1969).
15. Shambaugh GE, Mrozak SC, Freinkel N: Fetal fuels. I. Utilization of ketones by isolated tissues at various stages of maturation and maternal nutrition during late gestation. Metabolism 26 (6), 623-635 (1977).
16. Seccombe DW, Harding PG, Possmayer F: Fetal utilization of maternally derived ketone bodies for lipogenesis in the rat. Biochim. Biophys. Acta 488(3), 402-416 (1977).
17. Herrera E, Amusquivar E, Lopez-Soldado I, Ortega H: Maternal lipid metabolism and placental lipid transfer. Horm. Res. 65(Suppl. 3), 59-64 (2006).
18. Lederman SA, Paxton A, Heymsfield SB, Wang J, Thornton J, Pierson RN Jr: Body fat and water changes during pregnancy in women with different body weight and weight gain. Obstet. Gynecol. 90(4 Pt 1), 483-488 (1997).
19. Lawrence M, Coward WA, Lawrence F, Cole TJ, Whitehead RG: Fat gain during pregnancy in rural African women: the effect of season and dietary status. Am. J. Clin. Nutr. 45(6), 1442-1450 (1987).
20. Goldberg GR, Prentice AM, Coward WA et al.: Longitudinal assessment of energy expenditure in pregnancy by the doubly labeled water method. Am. J. Clin. Nutr. 57(4), 494-505 (1993).
21. Okereke NC, Huston-Presley L, Amini SB, Kalhan S, Catalano PM: Longitudinal changes in energy expenditure and body composition in obese women with normal and impaired glucose tolerance. Am. J. Physiol. Endocrinol. Metab. 287(3), E472-E479 (2004).
22. Kopp-Hoolihan LE, van Loan MD, Wong WW, King JC: Fat mass deposition during pregnancy using a four-component model. J. Appl. Physiol. 87(1), 196-202 (1999).
23. Pipe NG, Smith T, Halliday D, Edmonds CJ, Williams C, Coltart TM: Changes in fat, fat-free mass and body water in human normal pregnancy. Br. J. Obstet. Gynaecol. 86(12), 929-940 (1979).
24. Sohlstrom A, Wahlund LO, Forsum E: Total body fat and its distribution during human reproduction as assessed by magnetic resonance imaging. Basic Life Sci. 60, 181-184 (1993).
25. Ehrenberg HM, Huston-Presley L, Catalano PM: The influence of obesity and gestational diabetes mellitus on accretion and the distribution of adipose tissue in pregnancy. Am. J. Obstet. Gynecol. 189(4), 944-948(2003).
26. Pujol E, Proenza A, Llado I, Roca P: Pregnancy effects on rat adipose tissue lipolytic capacity are dependent on anatomical location. Cell Physiol. Biochem. 16(4-6), 229-236 (2005).
27. Zhang S, Folsom AR, Flack JM, Liu K: Body fat distribution before pregnancy and gestational diabetes: findings from Coronary Artery Risk Development In Young Adults (CARDIA) study. BMJ 311(7013), 1139-1140 (1995).
28. Ijuin H, Douchi T, Nakamura S, Oki T, Yamamoto S, Nagata Y: Possible association of body-fat distribution with preeclampsia. J. Obstet. Gynaecol. Res. 23(1), 45-49 (1997).
29. Sattar N, Clark P, Holmes A, Lean ME, Walker I, Greer IA: Antenatal waist circumference and hypertension risk. Obstet. Gynecol. 97(2), 268-271 (2001).
30. Bartha JL, Marin-Segura P, Gonzalez-Gonzalez NL, Wagner F, Aguilar-Diosdado M, Hervias-Vivancos B: Ultrasound evaluation of visceral fat and metabolic risk factors during early pregnancy. Obesity (Silver Spring) 15 (9), 2233-2239 (2007).
31. Kinoshita T, Itoh M: Longitudinal variance of fat mass deposition during pregnancy evaluated by ultrasonography: the ratio of visceral fat to subcutaneous fat in the abdomen. Gynecol. Obstet. Invest. 61(2), 115-118 (2006).
32. Einstein FH, Fishman S, Muzumdar RH, Yang XM, Atzmon G, Barzilai N: Accretion of visceral fat and hepatic insulin resistance in pregnant rats. Am. J. Physiol. Endocrinol. Metab. 294(2), E451-E455 (2008).
33. Gunderson EP, Sternfeld B, Wellons MF et al.: Childbearing may increase visceral adipose tissue independent of overall increase in body fat. Obesity (Silver Spring) 16(5), 1078-1084 (2008).
34. Fahraeus L, Larsson-Cohn U, Wallentin L: Plasma lipoproteins including high density lipoprotein subfractions during normal pregnancy. Obstet. Gynecol. 66(4), 468-472 (1985).
35. Sattar N, Greer IA, Louden J et al.: Lipoprotein subfraction changes in normal pregnancy: threshold effect of plasma, triglyceride on appearance of small, dense low density lipoprotein. J. Clin. Endocrinol. Metab. 82(8), 2483-2491 (1997).
36. Alvarez JJ, Montelongo A, Iglesias A, Lasuncion MA, Herrera E: Longitudinal study on lipoprotein profile, high density lipoprotein subclass, and postheparin lipases during gestation in women. J. Lipid Res. 37(2), 299-308 (1996).
37. Silliman K, Shore V, Forte TM: Hypertriglyceridemia during late pregnancy is associated with the formation of small dense low-density lipoproteins and the presence of large buoyant high-density lipoproteins. Metabolism 43(8), 1035-1041 (1994).
38. Stewart F, Rodie VA, Ramsay JE, Greer IA, Freeman DJ, Meyer BJ: Longitudinal assessment of crythrocyte fatty acid composition throughout pregnancy and post partum. Lipids 42(4), 335-344 (2007).
39. Sattar N, Berry C, Greer IA: Essential fatty acids in relation to pregnancy complications and fetal development. Br. J. Obstet. Gynaecol. 105(12), 1248-1255 (1998).
40. Haggarty P: Placental regulation of fatty acid delivery and its effect on fetal growth - a review. Placenta 23(Suppl. A), S28-S38 (2002).
41. Montgomery C, Speake BK, Cameron A, Sattar N, Weaver LT: Maternal docosahexaenoic acid supplementation and fetal accretion. Br. J. Nutr. 90(1), 135-145 (2003).
42. Woollett LA: Origin of cholesterol in the fetal golden Syrian hamster: contribution of de novo sterol synthesis and maternal-derived lipoprotein cholesterol. J. Lipid Res. 37(6), 1246-1257 (1996).
43. Plosch T, van Straten EM, Kuipers F: Cholesterol transport by the placenta: placental liver X receptor activity as a modulator of fetal cholesterol metabolism? Placenta 28 (7), 604-610. (2007).
44. Napoli C, D'Armiento FP, Mancini FP et al.: Fatty streak formation occurs in human fetal aortas and is greatly enhanced by maternal hypercholesterolemia. Intimal accumulation of low density lipoprotein and its oxidation precede monocyte recruitment into early atherosclerotic lesions. J. Clin Invest. 100(11) 2680-2690: (1997).
45. Ramsay JE, Greer I, Sattar N: ABC of obesity. Obesity and reproduction. Br. Med. J. 333(7579), 1159-1162 (2006).
46. Kanagalingam MG, Forouhi NG, Greer IA, Sattar N: Changes in booking body mass index over a decade: retrospective analysis from a Glasgow Maternity Hospital. BJOG 112(10), 1431-1433 (2005).
47. Butte NF, Wong WW, Treuth MS, Ellis KJ, O'Brian Smith E: Energy requirements during pregnancy based on total energy expenditure and energy deposition. Am. J. Clin. Nutr. 79(6), 1078-1087 (2004).
48. Prentice AM, Goldberg GR, Davies HL Murgatroyd PR, Scott W: Energy-sparing adaptations in human pregnancy assessed by whole-body calorimetry. Br. J. Nutr, 62(1); 5-22 (1989).
49. Eckel RH: Insulin resistance: an adaptation for weight maintenance. Lancet 340 (8833), 1452-1453 (1992).
50. Merzouk H, Meghelli-Bouchenak M, Loukidi B, Prost J, Belleville J: Impaired serum lipids and lipoproteins in fetal macrosomia related to maternal obesity. Biol. Neonate 77(1), 17-24 (2000).
51. Ramsay JE, Ferrell WR, Crawford L, Wallace AM, Greer IA, Sattar N: Maternal obesity is associated with dysregulation of metabolic, vascular, and inflammatory pathways. J. Clin. Endocrinol. Metab. 87(9), 4231-4237 (2002).
52. Sattar N, Tan CE, Han TS et al.: Associations of indices of adiposity with atherogenic lipoprotein subfractions. Int. J. Obes. Relat. Metab. Disord. 22(5), 432-439 (1998).
53. Alberri KG, Zimmet PZ: Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet. Med. 15 (7), 539-553 (1998).
54. Sermer M, Naylor CD, Farine D et al.: The Toronto Tri-Hospital Gestational Diabetes Project. A preliminary review. Diabetes Care 21(Suppl. 2), B33-B42 (1998).
55. Hunt KJ, Schuller KL: The increasing prevalence of diabetes in pregnancy. Obstet. Gynecol. Clin. North Am. 34(2), 173-199, vii(2007).
56. Crowther CA, Hiller JE, Moss JR, McPhee AJ, Jeffries WS, Robinson JS: Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N. Engl. J. Med. 352(24), 2477-2486 (2005).
57. Metzger-BE: Long-term outcomes in mothers diagnosed with gestational diabetes mellitus and their offspring. Clin. Obstet. Gynecol. 50(4), 972-979 (2007).
58. Catalano PM, Tyzbir ED, Wolfe RR, Roman NM, Amini SB, Sims EA: Longitudinal changes in basal hepatic glucose production and suppression during insulin infusion in normal pregnant women. Am. J. Obstet. Gynecol. 167(4 Pt 1); 913-919 (1992).
59. Catalano PM, Tyzbir ED, Wolfe RR et al.: Carbohydrate metabolism during pregnancy in control subjects and women with gestational diabetes. Am. J. Physiol. 264(1 Pt 1), E60-E67 (1993).
60. Catalano PM, Huston L Amini SB Kalhan SC: Longitudinal changes in glucose metabolism during pregnancy in obese women with normal glucose tolerance and gestational diabetes mellitus. Am. J. Obstet. Gynecol. 180(4), 903-916 (1999).
61. Couch SC, Philipson EH, Bendel RB, Pujda LM, Milvae RA, Lammi-Keefe CJ: Elevated lipoprotein lipids and gestational hormones in women with diet-treated gestational diabetes mellitus compared with healthy pregnant controls. J. Diabetes Complications 12(1), 1-9 (1998).
62. Sanchez-Vera I, Bonet B, Viana M et al.: Changes in plasma lipids and increased low-density lipoprotein susceptibility to oxidation in pregnancies complicated by gestational diabetes: consequences of obesity. Metabolism 56(11), 1527-1533 (2007).
63. Xiang AH, Peters RK, Trigo E, Kjos SL, Lee WP, Buchanan TA: Multiple metabolic defects during late pregnancy in women at high risk for Type 2 diabetes. Diabetes 48(4), 848-854 (1999).
64. Sattar N, Greer I: Lipids and the pathogenesis of pre-eclampsia. Curr. Obstet. Gynaecol. 9, 190-195 (1999).
65. Ness RB, Roberts JM: Heterogeneous causes constituting the single syndrome of preeclampsia: a hypothesis and its itnplications. Am. J. Obstet. Gynecol. 175(5), 1365-370 (1996).
66. Rodie VA, Freeman DJ, Sattar N, Greer IA: Pre-eclampsia and cardiovascular disease: metabolism syndrome of pregnancy? Atherosclerosis 175(2), 189-202 (2004).
67. Zhang C, Austin MA, Edwards KL et al.: Functional variants of the lipoprotein lipase gene and the risk of preeclampsia among non-Hispanic Caucasian women. Clin. Genet. 69(1), 33-39 (2006).
68. Potter JM, Nestel PJ:The hyperlipidemia of pregnancy in normal and complicated pregnancies. Am. J. Obstet. Gynecol. 133(2), 165-170 (1979).
69. Sattar N, Bendomir A, Berry C, Shepherd J, Greer IA, Packard CJ: Lipoprotein subfraction concentrations in preeclampsia: pathogenic parallels to atherosclerosis. Obstet. Gynecol. 89(3), 403-408 (1997).
70. Ramsay JE, Ferrell WR, Crawford L, Wallace AM, Greer IA, Sattar N: Divergent metabolic and vascular phenotypes in pre-eclampsia and intrauterine growth restriction: relevance of adiposity. J. Hypertens. 22(11), 2177-2183 (2004).
71. Vadachkoria S, Woelk GB, Mahomed K et al.: Elevated soluble vascular cell adhesion molecule-1, elevated homocyst(e)inemia, and hypertriglyceridemia in relation to. preeclampsia risk. Am. J. Hypertens. 19 (3), 235-242 (2006).
72. Lorentzen B, Enderson M, Clausen T, Henriksen T: Fasting serum free fatty acids and triglycerides are increased before 20 weeks of gestation in women who later develop pre-eclampsia. Hypertens. Pregnancy 13, 103-119 (1994).
73. Enquobahrie DA, Williams MA, Butler CL, Frederick IO, Miller RS, Luthy DA: Maternal plasma lipid concentrations in early pregnancy and risk of preeclampsia. Am. J. Hypertens. 17(7), 574-581 (2004).
74. Belo L, Caslake M, Gaffney D et al.: Changes in LDL size and HDL concentration in normal and preeclamptic pregnancies. Atherosclerosis 162 (2), 425-432 (2002).
75. Llurba E, Casais E, Dominguez C et al.: Atherogenic lipoprotein subfraction profile in preedamptic women with and without high triglycerides: different pathophysiologic subsets in preeclampsia. Metabolism 54(11), 1504-1509 (2005).
76. Hubel CA, Shakir Y, Gallaher MJ, McLaughlin MK, Roberts JM: Low-density lipoprotein particle size decreases during normal pregnancy in association with triglyceride increases. J. Soc. Gynecol. Investig. 5(5), 244-250 (1998).
77. Griffin BA, Freeman DJ, Tait GW et al.: Role of plasma triglyceride in the regulation of Dasma low density lipoprotein (LDL) subfractions: relative contribution of small, dense LDL to coronary heart disease risk. Atherosclerosis 106(2), 241-253 (1994).
78. Hubel CA, Lyall F, Weissfeld L, Gandley RE, Roberts JM: Small low-density lipoproteins and vascular cell adhesion molecule-1 are increased in association with hyperlipidemia in preeclampsia. Metabolism 47(10), 1281-1288 (1998).
79. Hubel CA, McLaughlin MK, Evans RW, Hauth BA, Sims CJ, Roberts JM: Fasting serum triglycerides, free fatty acids, and malondialdehyde are increased in preeclampsia, are positively correlated, and decrease within 48 hours post partum. Am. J. Obstet. Gynecol. 174(3), 975-982 (1996).
80. Pavan L, Tsatsaris V, Hermouet A, Therond P, Evain-Brion D, Fournier T: Oxidized low-density lipoproteins inhibit trophoblastic cell invasion. J. Clin. Endocrinol. Metab. 89(4), 1969-1972 (2004).
81. Ware-Jauregui S, Sanchez SE, Zhang C, Laraburre G, King IB, Williams MA: Plasma lipid concentrations in preeclamptic and normotensive Peruvian women. Int. J. Gynaecol. Obstet. 67(3), 147-155 (1999).
82. Homko CJ, Cheung P, Boden G: Effects of free fatty acids on glucose uptake and utilization in healthy women. Diabetes 52(2), 487-491 (2003).
83. Belfort R, Mandarino L, Kashyap S et al.: Dose-response effect of elevated plasma free fatty acid on insulin signaling. Diabetes 54(6), 1640-1648 (2005).
84. Inoguchi T, Li P, Umeda F et al.: High glucose level and free fatty acid stimulate reactive oxygen species production through protein kinase C-dependent activation of NAD (P)H oxidase in cultured vascular cells. Diabetes 49(11), 1939-1945 (2000).
85. Pleiner J, Schaller G, Mittermayer F, Bayerle-Eder M, Roden M, Wolzt M: FFA-induced endothelial dysfunction can be corrected by vitamin C. J. Clin. Endocrinol. Metab. 87(6), 2913-2917 (2002).
86. Sivan E, Homko CJ, Whittaker PG, Reece EA, Chen X, Boden G: Free fatty acids and insulin resistance during pregnancy. J. Clin. Endocrinol. Metab. 83(7), 2338-2342 (1998).
87. Endresen MJ, Lorentzen B, Henriksen T: Increased lipolytic activity and high ratio of free fatty acids to albumin in sera from women with preeclampsia leads to triglyceride accumulation in cultured endothelial cells. Am. J. Obstet. Gynecol. 167(2), 440-447 (1992).
88. Endresen MJ, Morris JM, Nobrega AC, Buckley D, Linton EA, Redman CW: Serum from preeclamptic women induces vascular cell adhesion molecule-1 expression on human endothelial cells in vitro: a possible role of increased circulating levels of free fatty acids. Am. J. Obstet. Gynecol. 179(3 Pt 1), 665-670 (1998).
89. Suganami T, Nishida J, Ogawa Y: A paracrine loop between adipocytes and macrophages aggravates inflammatory changes: role of free fatty acids and tumor necrosis factor α. Arterioscler. Thromb. Vasc. Biol. 25(10), 2062-2068 (2005).
90. Florez H, Castillo-Florez S, Mendez A et al. C-reactive protein is elevated in obese patients with the metabolic syndrome. Diabetes Res. Clin. Pract. 71(1), 92-100 (2006).
91. Hannaford P, Ferry S, Hirsch S: Cardiovascular sequelae of toxaemia of pregnancy. Heart 77(2), 154-158 (1997).
92. Jonsdottir LS, Arngrimsson R, Geirsson RT, Sigvaldason H, Sigfusson N: Death rates from ischemic heart disease in women with a history of hypertension in pregnancy. Acta Obstet. Gynecol. Scand. 74(10), 772-776 (1995).
93. Smith GC, Pell JP, Walsh D: Pregnancy complications and maternal risk of ischaemic heart disease: a retrospective cohort study of 129,290 births. Lancet 357(9273), 2002-2006 (2001).
94. Ray JG, Vermeulen MJ, Schull MJ, Redelmeier DA: Cardiovascular Health After Maternal Placental Syndromes (CHAMPS): population-based retrospective cohort study. Lancet 366(9499), 1797-1803 (2005).
95. Bellamy L, Casas JP, Hingorani AD, Williams DJ: Pre-eclampsia and risk of cardiovascular disease and cancer in later life: systematic review and meta-analysis. Br. Med. J. 335(7627), 974 (2007)
96. Green A, Beral V, Moser K: Mortality in women in relation to their childbearing history. Br. Med. J. 297(6645), 391-395 (1988).
97. Ness RB, Harris T, Cobb J et al.: Number of pregnancies and the subsequent risk of cardiovascular disease. N. Engl. J. Med. 328(21), 1528-1533 (1993).
98. Lawlor DA, Emberson JR, Ebrahim S et al.: Is the association between parity and coronary heart disease due to biological effects of pregnancy or adverse lifestyle risk factors associated with child-rearing? Findings from the British Women's Heart and Health. Study and the British Regional Heart Study. Circulation 107(9), 1260-1264 (2003).
99. Callaway LK, Lawlor DA, O'Callaghan M, Williams GM, Najman JM, McIntyre HD: Diabetes mellitus in the 21 years after a pregnancy that was complicated by hypertension: findings from a prospective cohort study. Am. J. Obstet. Gynecol. 197(5), 492 E491-E497 (2007).
100. Sattar N, Greer IA: Pregnancy complications and maternal cardiovascular risk: opportunities for intervention and screening? Br. Med. J. 325(7356), 157-160 (2002).