Patricia Dietz, DrPH
Team Leader, Research and Evaluation Team, Applied Sciences Branch, Division of Reproductive Health, Centers for Disease Control and Prevention
Patrick Catalano, MD
Chief, Infant, Child and Women's Health, National Center for Health Statistics
Ellen Seely, MD
Director of Clinical Research in the Endocrinology,
Diabetes and Hypertension Division
Vice Chair for Faculty Development in the Department of Medicine
Brigham and Women's Hospital
Assiamira Ferrara, MD, PhD
Senior Scientist, Kaiser Northern California
Shadi Chamany, MD, MPH
Director of the Diabetes Prevention and Control Program at the New York City Department of Health and Mental Hygiene
The intersection of pregnancy and chronic disease encompasses health implications for the woman and for the child. Women with chronic diseases not only face their own health problems, but their infants have increased risks of poor outcomes. Conditions identified during pregnancy, such as gestational diabetes and hypertension, reveal future risk of cardiovascular and metabolic diseases for the woman and immediate risk of poorer outcomes for the infant. Pregnancy provides an opportunity to identify chronic disease risk among women who are in need of education, counseling, and appropriate follow up to address their long-term health risks.
Approximately 30% of women of reproductive age are obese, and one in four women will develop diabetes in their lifetime. During pregnancy, 4-7% of women experience gestational diabetes, a condition that indicates a high risk for future development of type 2 diabetes, and approximately 5% experience preeclampsia, which is associated with increased future risk of cardiovascular disease, the number one cause of death among women in the US. Effective interventions exist for diabetes prevention. For women with a history of preeclampsia, little is known about how to best prevent cardiovascular disease. However, lifestyle interventions to reduce obesity and diabetes may also reduce risk of cardiovascular disease.
The purpose of this plenary session is to provide a state-of –the-art update on the epidemiology of obesity, gestational diabetes and hypertension, their effect on pregnancy outcomes, and how gestational diabetes and hypertension identify future risk of chronic disease. In addition, our speakers will discuss their research on interventions to offset those risks. Participants will come away with an understanding of the epidemiology of these conditions, current clinical recommendations, research on effective interventions, and directions for future research and programmatic needs.
At the conclusion of this plenary session, the audience will have a better understanding of:
- The epidemiology of obesity, gestational diabetes and hypertension, and effect on pregnancy outcomes, future disease risk for the mother.
- Clinical recommendations for screening before, during, and after pregnancy.
- Effective interventions for risk reduction and prevention of diabetes among women with previous gestational diabetes.
- Current research on interventions for preventing cardiovascular disease among women with a history of preeclampsia.
- Future needs for research with special emphasis on the role of state MCH epidemiologists in addressing these needs.