Introduction:
Preterm delivery (<37 weeks) predicts 2 to 3-fold greater risk of cardiovascular disease in mothers. Development of subclinical cardiovascular risk in these women prior to and following pregnancy is not well understood.
Hypothesis:
Women who deliver preterm have an adverse cardiovascular health profile even prior to pregnancy.
Methods:
Linked data from the population-based, longitudinal HUNT study (1984-2008) and the Medical Birth Registry of Norway (1967-2012) yielded clinical measurements and pregnancy outcomes for 23,179 parous women. Women had up to 3 measurements of body mass index, waist circumference, blood pressure, non-fasting lipids and glucose, and high-sensitivity C-reactive protein (hs-CRP) during a follow-up period between 20 years before first birth to 41 years after first birth. We used mixed effects linear spline models, adjusting for age, pre-pregnancy smoking, education, and time since last meal, to compare risk factor trajectories for women with preterm versus term/postterm first births.
Results:
Women with a preterm first birth (n=1,402, 6%) had significantly higher triglyceride (Figure 1 A) and glucose levels prior to pregnancy. They also experienced steeper increases in systolic and diastolic blood pressure, non-HDL cholesterol, triglycerides, and hs-CRP from first birth to age 50 compared to women who delivered at term/post-term (Figure 1 A,B). Measures of adiposity were similar throughout the life course.
Conclusions:
These results are consistent with the hypothesis that preterm birth is an early marker of cardiometabolic impairment. A history of preterm birth may predict high cardiovascular risk well before the development of traditional risk factors.
Changes in Body Weight From Young Adulthood to Middle Age and Its Association With Blood Pressure and Hypertension: A Cross‐Sectional Study in Hong Kong Chinese Women
