Pregnancy is characterized by profound metabolic and physiological alterations involving virtually every organ system. Among apparently healthy women, the metabolic challenges, or “stress test” of pregnancy may contribute to adverse perinatal and neonatal outcomes, and may also unmask susceptibility for maternal chronic disorders. Available clinical and epidemiologic data are supportive of the hypothesis that common medical complications of pregnancy including gestational diabetes mellitus, and hypertensive disorders of pregnancy may represent, at least for some women, their underlying risk for developing related chronic medical conditions as they age. This chapter first provides a brief overview of maternal metabolic, physiological, and anatomical changes during pregnancy. These are followed by a review of selected maternal pre-gestational chronic medical conditions and those arising during pregnancy. The chapter closes with a discussion of the influence of other factors, including intimate partner violence, on maternal physical and mental well-being.
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