TY - JOUR T1 - Pre-eclampsia and maternal placental syndromes: an indicator or cause of long-term cardiovascular disease? JF - Heart JO - Heart SP - 1109 LP - 1111 DO - 10.1136/heartjnl-2012-302076 VL - 98 IS - 15 AU - Dawn C Scantlebury AU - Sharonne N Hayes AU - Vesna D Garovic Y1 - 2012/08/01 UR - http://heart.bmj.com/content/98/15/1109.abstract N2 - Maternal placental syndromes (MPS) occur as a consequence of abnormal placental vessel formation, and refer to hypertensive pregnancy disorders (HPDs) and related placental abnormalities, such as placental abruption and infarction.1 In the affected pregnancies, adverse pregnancy outcomes, including preterm delivery, foetal growth retardation and intrauterine foetal demise, are common. HPDs complicate about 5–10% of pregnancies worldwide2 and cover a spectrum of conditions. Most notable among these is preeclampsia, a multisystem pregnancy-specific disorder clinically characterised by hypertension and proteinuria, and which remains a leading cause of foetal and maternal morbidity and mortality. Evidence suggests that preeclampsia is associated with the release of antiangiogenic factors by an ischaemic placenta, which, in turn, may lead to maternal endothelial dysfunction.3 ,4In 1927, Corwin and Herrick reported an association between ‘hypertensive toxemia of pregnancy’, as pre-eclampsia was once called, and chronic cardiovascular disease.5 Since then, there have been multiple epidemiological studies that confirm these authors' observation. HPDs have been associated with chronic hypertension, ischaemic heart disease, stroke, venous thromboembolism and cardiovascular death6 ,7; evidence suggests that other features of the metabolic syndrome are present as well.8 Similarly, the development of an MPS has been shown to double the risk of development of cardiovascular disease later on in life.1 However, studies evaluating an association between HPDs and future arrhythmias and heart failure are limited.In this issue of Heart Ray9 discusses these specific cardiovascular outcomes, heart failure and arrhythmias, in the context of a previous history of MPSs (see page 1136). In this unique retrospective cohort study, using a large administrative database in Ontario, Canada, the authors evaluate the frequency of these two outcomes in women with previous MPSs, defined as placental abruption, … ER -