In Reply We agree with Sciatti and Orabona that the described obstetric complications (eg, preeclampsia, hypertensive disorders of pregnancy, gestational diabetes) are associated with higher postpartum cardiovascular risk. The Women’s Health Study (WHS) enrolled participants from 1993 through 1996, and the baseline WHS questionnaire did not include questions on obstetrical complications, precluding a formal analysis in our study,¹ as astutely suggested by Sciatti and Orabona. The growing field of cardio-obstetrics has increased focus on the influence of obstetric hemodynamic, valvular, and structural heart changes on postpartum cardiovascular risk, as outlined in the recent scientific statement from the American Heart Association.² We agree that future work should integrate obstetric history and complications in relation to cardiovascular risk in women. This work could improve risk stratification and guide interventions for better primary cardiovascular prevention, in particular for younger women.

在答复中，我们同意 Sciatti 和 Orabona 的观点，即所描述的产科并发症（例如先兆子痫、妊娠高血压疾病、妊娠糖尿病）与较高的产后心血管风险相关。妇女健康研究 (WHS) 从 1993 年到 1996 年招募了参与者，并且基线 WHS 调查问卷不包括有关产科并发症的问题，从而排除了我们研究中的正式分析， ¹正如 Sciatti 和 Orabona 精明地建议的那样。正如美国心脏协会最近的科学声明所述，不断发展的心脏产科领域越来越关注产科血流动力学、瓣膜和心脏结构变化对产后心血管风险的影响。 ²我们同意未来的工作应整合与女性心血管风险相关的产科病史和并发症。这项工作可以改善风险分层并指导干预措施，以实现更好的初级心血管预防，特别是对于年轻女性。