Table 1.

Future directions and key research questions

Areas of investigation	Future directions and key research questions
Preeclampsia	Are there specific proteomic, metabolomic, and epigenomic profiles that are correlated with increased risk for CVD and heart failure? What is the relationship between pro/anti-angiogenic factors and endothelial function? Does controlling postpartum and long-term blood pressure reduce CVD risk in women with a history of preeclampsia?
Gestational diabetes	Are there biomarkers that can predict future CVD in women with a history of GDM? What is the relationship between markers of inflammation and endothelial dysfunction and risk of future CVD in women with GDM? Do these markers help predict groups at greatest risk for developing CVD later in life? What is the role of anti-hyperglycemic medications in the prevention of CVD in women with GDM?
Preterm delivery	What are the mechanisms underlying the association between preterm delivery and CVD? Does prophylactic use of aspirin prevent spontaneous preterm delivery?
Pathophysiology	Are APOs causal of CVD pathogenesis or merely unmask a woman’s pre-existing CVD risk? What are the biologic mechanisms leading to future maternal CVD and heart failure after APOs? Are there pathophysiologic mechanisms underlying socioeconomic and racial disparities in APOs?
Risk prediction and interventions	What are the appropriate methods and frequency of screening for CVD and CVD risk factors after delivery? Who should be screened? Does reducing modifiable risk factors decrease CVD risk in women with history of APOs? Why do APOs fail to enhance predictive discrimination for CVD in risk prediction models despite their well-established associations with future CVD events? What is the best method to identify women with APOs at high risk for future CVD?

APO adverse pregnancy outcome, CVD cardiovascular disease