- Women who experience certain pregnancy-related complications should be screened for heart disease and type 2 diabetes beginning in their late 30s, researchers suggest. These women are also candidates for counseling about the benefits of diet and exercise in lowering their risk of vascular disorders, according to Drs. Naveed Sattar and Ian A. Greer of Glasgow Royal Infirmary in Scotland. "Clearly, women with a history of gestational diabetes are candidates for screening for diabetes," they write. "If other adverse pregnancy outcomes...are confirmed as indicators of increased vascular risk in mothers, these women may benefit from screening and primary prevention strategies." Their article in the July 20th issue of the British Medical Journal notes that women who develop gestational diabetes have a higher risk of type 2 diabetes later in life. Studies are now beginning to link other pregnancy complications--including preterm delivery, low-birth weight babies and preeclampsia--with heart and blood vessel disease. The article suggests that general practitioners keep computerized records of pregnancy complications in order to make sure that women are targeted for screening and education, beginning as early as the 6-week postpartum checkup. Women who experience pregnancy complications should undergo routine screening procedures such as blood pressure, cholesterol and blood glucose (sugar) measurements, the authors state. "A major problem in the prevention of vascular disease has been the difficulty in identifying individuals at risk at an early enough stage for them to benefit from intervention such as modification of their lifestyle," the researchers note. So identifying women at risk in their late 30s would be a step forward. Although diet and exercise can lower the risk of heart disease and type 2 diabetes, it is not clear whether these lifestyle factors also reduce the risk of pregnancy-related complications. SOURCE: British Medical Journal 2002;325:157-160. (juli 2002)