Assisted Reproductive Technologies and Their Association With Adverse Pregnancy Outcomes and Long-Term Cardiovascular Disease: Implications for Counseling Patients

2021 ◽  
Vol 23 (8) ◽  
Author(s):  
Ki Park ◽  
Emily Allard-Phillips ◽  
Gregory Christman ◽  
Michelle Dimza ◽  
Alice Rhoton-Vlasak
Keyword(s):  
Cardiovascular Disease ◽  
Pregnancy Outcomes ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Pregnancy

Abstract 376: Adverse Pregnancy Outcomes and Cardiovascular Risks Multi-disciplinary Awareness Project

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Venkata Sai Gogineni ◽  
Ki Park ◽  
Denise Manfrini ◽  
Robert Egerman ◽  
Sharon Aroda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pregnancy Outcomes ◽  
Descriptive Analysis ◽  
Primary Objective ◽  
Adverse Pregnancy Outcomes ◽  
Cardiovascular Risks ◽  
Cvd Risk ◽  
Adverse Pregnancy ◽  
Traditional Risk Factors

Background: Cardiovascular disease (CVD) remains the number one cause of death amongst women. There has been much effort put forth over the past decade in reducing both the incidence and prevalence of this disease burden through screening and treating the traditional risk factors. Recent guidelines have shown that adverse pregnancy outcomes (APOs), including pre-eclampsia (PEC), gestational diabetes mellitus (GDM) and pre-term birth (PTB) have been associated with future maternal CVD risk. Much of the current literature focuses almost exclusively on PEC. Our investigation is more comprehensive, covering not only these other APOs but assessing whether providers of multiple specialties in our community are aware of the APO to CVD risk association. The primary objective of this study was to investigate if there exist any knowledge gaps regarding the progression from APO to CVD and if this knowledge varies by specialty. Methods: An anonymous voluntary survey through REDCap© was sent to providers in the fields of Internal medicine (IM, 21%), Family medicine (FM, 26%), Obstetrics-Gynecology (Ob-Gyn, 23%) and Cardiology (30%) who have been in practice for greater than five years in our local Gainesville community. This project was registered as a QI project and descriptive analysis was used to examine the responses. Results: A total of 53 providers responded to the survey. Despite having the majority of patients being women, Ob-Gyn was the least likely amongst all specialties to routinely screen for CV risk factors. However, when addressed, they were the most likely to ask about APOs. Cardiologists, despite declaring to be aware of the association between APOs and CV risk, were least likely to ask about APOs. All specialties recognized PEC and GDM as APOs linked to long-term maternal CV risk but failed to associate PTB as an APO. The majority of providers amongst IM, FM, and Cardiology did not ask about APOs and lacked the knowledge of how often to appropriately screen for secondary risk factors associated with APOs. Additionally, these providers outright admitted that they are not familiar with the current AHA and/or ACOG guidelines for screening and follow-up. Conclusion: Descriptive statistical analysis of our data suggests that there exists a notable knowledge gap between all four specialties investigated in our survey. Education concerning the link between APOs and future maternal CV risk is needed amongst all specialties, especially amongst the providers in Cardiology, IM, and FM. Targeted efforts at our institution to improve awareness of all APOs, their associated secondary risk factors, and appropriate screening is required in all specialties to help reduce CVD morbidity and mortality.

scholarly journals Long-Term Cardiovascular Risks Associated With Adverse Pregnancy Outcomes

2019 ◽  
Vol 73 (16) ◽  
pp. 2106-2116 ◽  
Author(s):  
Abbi D. Lane-Cordova ◽  
Sadiya S. Khan ◽  
William A. Grobman ◽  
Philip Greenland ◽  
Sanjiv J. Shah
Keyword(s):  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Cardiovascular Risks ◽  
Adverse Pregnancy

Adverse Pregnancy Outcomes Are Associated With Coronary Artery and Cardiovascular Disease Risk

2006 ◽  
Vol 107 (Supplement) ◽  
pp. 27S
Author(s):  
Monique V. Chireau ◽  
Mimi Biswas ◽  
Emily Honeycutt ◽  
Haywood Brown ◽  
L Kristin Newby ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery ◽  
Pregnancy Outcomes ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Pregnancy

Do adverse pregnancy outcomes contribute to accelerated cardiovascular events seen in young women with systemic lupus erythematosus?

Lupus ◽  
2017 ◽  
Vol 26 (13) ◽  
pp. 1351-1367 ◽  
Author(s):  
M C Soh ◽  
C Nelson-Piercy ◽  
M Westgren ◽  
L McCowan ◽  
D Pasupathy
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Cardiovascular Disease ◽  
Young Women ◽  
Lupus Erythematosus ◽  
Pregnancy Outcomes ◽  
Cardiovascular Events ◽  
Adverse Pregnancy Outcomes ◽  
Systemic Lupus ◽  
Adverse Pregnancy

Cardiovascular events (CVEs) are prevalent in patients with systemic lupus erythematosus (SLE), and it is the young women who are disproportionately at risk. The risk factors for accelerated cardiovascular disease remain unclear, with multiple studies producing conflicting results. In this paper, we aim to address both traditional and SLE-specific risk factors postulated to drive the accelerated vascular disease in this cohort. We also discuss the more recent hypothesis that adverse pregnancy outcomes in the form of maternal–placental syndrome and resultant preterm delivery could potentially contribute to the CVEs seen in young women with SLE who have fewer traditional cardiovascular risk factors. The pathophysiology of how placental-mediated vascular insufficiency and hypoxia (with the secretion of placenta-like growth factor (PlGF) and soluble fms-tyrosine-like kinase-1 (sFlt-1), soluble endoglin (sEng) and other placental factors) work synergistically to damage the vascular endothelium is discussed. Adverse pregnancy outcomes ultimately are a small contributing factor to the complex pathophysiological process of cardiovascular disease in patients with SLE. Future collaborative studies between cardiologists, obstetricians, obstetric physicians and rheumatologists may pave the way for a better understanding of a likely multifactorial aetiological process.

scholarly journals Adverse Pregnancy Outcomes and Long-term Maternal Kidney Disease

2020 ◽  
Vol 3 (2) ◽  
pp. e1920964 ◽  
Author(s):  
Peter M. Barrett ◽  
Fergus P. McCarthy ◽  
Karolina Kublickiene ◽  
Sarah Cormican ◽  
Conor Judge ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Pregnancy

Impact of heart disease on maternal, fetal and neonatal outcomes in a low-resource setting

Heart ◽  
2018 ◽  
Vol 105 (10) ◽  
pp. 755-760 ◽  
Author(s):  
Andrea Beaton ◽  
Emmy Okello ◽  
Amy Scheel ◽  
Alyssa DeWyer ◽  
Renny Ssembatya ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Pregnancy Outcomes ◽  
Attributable Risk ◽  
Case Finding ◽  
Adverse Pregnancy Outcomes ◽  
Active Case Finding ◽  
Adverse Pregnancy ◽  
Rheumatic Heart

BackgroundThe burden of pre-existing cardiovascular disease and the contribution to adverse pregnancy outcomes are not robustly quantified, particularly in low-income countries. We aimed to determine both the prevalence of maternal heart disease through active case finding and its attributable risk to adverse pregnancy outcomes.MethodsWe conducted a 24-month prospective longitudinal investigation in three Ugandan health centres, using echocardiography for active case finding during antenatal care. Women with and without heart disease were followed to 6 weeks post partum to determine pregnancy outcomes. Prevalence of heart disease was calculated. Per cent attributable risk estimates were generated for maternal, fetal and neonatal mortality.ResultsScreening echocardiography was performed in 3506 women. The prevalence of heart disease was 17 per 1000 women (95% CI 13 to 21); 15 per 1000 was rheumatic heart disease. Only 3.4% of women (2/58) had prior diagnosis. Cardiovascular complications occurred in 51% of women with heart disease, most commonly heart failure. Per cent attributable risk of heart disease on maternal mortality was 88.6% in the exposed population and 10.8% in the overall population. Population attributable risk of heart disease on fetal death was 1.1% and 6.0% for neonatal mortalityConclusionsOccult maternal heart disease may be responsible for a substantial proportion of adverse pregnancy outcomes in low-resource settings. Rheumatic heart disease is, by far, the most common condition, urging global prioritisation of this neglected cardiovascular disease.

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