Pregnancy and the postpartum period are times of high risk for cardiovascular disease. The increase in maternal age at first pregnancy, obesity, and chronic conditions among pregnant women leads to an increased cardiovascular risk during pregnancy and the postpartum period. Certain complications, such as pregnancy-induced hypertension or gestational diabetes, can increase women’s cardiovascular risk for several years after childbirth.

Consequently, surveillance and prevention by Santé publique France are essential.

Epidemiological surveillance of vascular diseases in pregnancy

Surveillance of vascular diseases during pregnancy relies on the use of several data sources:

• The National Health Data System (SNDS), which includes:

  • hospitalization data from the Medicalization Program of the Hospitalization Information Systems of the Technical Agency for Hospitalization Information;

  • health care utilization data from the National Inter-Regime Health Insurance Information System of the National Health Insurance Fund and its general practitioner beneficiary sample (EGB; a 1/97th sample of the Sniiram);

  • data on medical causes of death from the Center for Epidemiology on Medical Causes of Death (CépiDc) of the National Institute of Health and Medical Research.

• The CONCEPTION cohort (derived from SNDS data): this cohort of 6.3 million births and 4.4 million women enabled the study of the prevalence of hypertensive disorders of pregnancy and their association with cardiovascular and cerebrovascular diseases in women in the years following childbirth.

• Data from the maternal mortality surveillance and analysis system established and managed by Inserm (EPOPé team).

• Data from the national perinatal survey on the health status of mothers and newborns (characteristics, medical practices, delivery locations), implemented by the Directorate General for Health, the Directorate General for Healthcare Provision, the Directorate for Research, Studies, Evaluation, and Statistics, Santé publique France, and the EPOPé team at Inserm.

Based on these databases, Santé publique France produced indicators on the prevalence and incidence of various cardiovascular complications during pregnancy and the postpartum period, particularly regarding the occurrence of a pregnancy-induced hypertensive disorder or a cardiovascular event (venous thrombosis, acute coronary syndrome, stroke, heart failure).

An epidemiology thesis was conducted within the agency on the link between blood pressure disorders during pregnancy (or pregnancy-induced hypertension) and cardiovascular risk in mothers in the years following childbirth. This research has been the subject of several scientific publications.

Finally, Santé publique France participates, by leading the National Expert Committee on Maternal Mortality, in the review of the circumstances of each maternal death to establish whether there is a direct or indirect link between the death and pregnancy and to determine whether the death was preventable.

Preventive action against vascular diseases of pregnancy

Santé publique France informs its stakeholders (ministry, policymakers, learned societies, patient associations, etc.) and recommends appropriate preventive measures, such as lifestyle and dietary guidelines to reduce the risk of vascular diseases at different stages of women’s lives, particularly during pregnancy.

JACARDI Pilot Project: Preventing Cardiovascular Risk After a High-Risk Pregnancy

As part of the European JACARDI initiative (Joint Action on Cardiovascular Diseases and Diabetes, funded by EU4Health), Santé publique France is piloting an innovative initiative. Its objective:

• To assess the feasibility and effectiveness of an information and prevention intervention aimed at women who experienced hypertension during pregnancy, with a particular focus on those with low health literacy.

• Encourage the adoption of healthier lifestyles to reduce their future cardiovascular risk.

• Raise awareness among healthcare professionals about the link between obstetric complications and cardiovascular risk in women.

This project, developed in collaboration with healthcare professionals and the women themselves, aims to strengthen prevention and personalized support.

1000-premiers-jours.fr: a website to inform and support parents

The “1,000 First Days” website, developed by Santé publique France, informs and supports parents during pregnancy and the child’s first two years. It offers:

• nutrition advice tailored to pregnant women;

• promotion of moderate physical activity, a key factor in reducing the risk of cardiovascular complications.

These recommendations are also available on mangerbouger.fr, in the dedicated “Expectant Mothers” section.

Tools and resources for professionals

Santé publique France provides:

• methodological resources for designing health promotion and parenting support initiatives;

• scientifically validated informational documents covering protective behaviors to adopt before, during, and after pregnancy.

These ready-to-use materials facilitate communication with families and strengthen prevention efforts.