Abstract 18819: Adverse Pregnancy Outcomes and Their Prediction of Future Heart Disease

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Paul-Ann Green ◽  
Dmitry Fridman ◽  
Heather Smith ◽  
Mary Rosser
Keyword(s):  
Pregnancy Outcomes ◽  
Intrauterine Growth Restriction ◽  
Stress Test ◽  
Cvd Risk ◽  
Intrauterine Growth ◽  
Index Pregnancy ◽  
Exposed Population ◽  
Increased Risk ◽  
Adverse Pregnancy

Objective: Pregnancy provides an opportunity for a natural stress test, with the physiological demands of pregnancy acting as a maternal stress test that can predict a woman’s health later in life. The 2011 Update of the American Heart Association’s Evidence-Based Guidelines for the Prevention of Cardiovascular Disease in Women identifies many complications of pregnancy as relevant in the determination of cardiovascular disease (CVD) risk. This is important because CVD is the leading cause of death in women worldwide. The purpose of this research was to determine if, in our diverse inner city population, pregnancies complicated by hypertensive disorders, gestational diabetes, intrauterine growth restriction, or abruption were associated with future development of CVD. Methods: We identified women who delivered at a large, urban hospital in Bronx, NY from 1997-2001 who were treated for gestational diabetes, hypertensive disorders of pregnancy, intrauterine growth restriction, and placental abruption (n=183). A hospital database was used to identify our cohort and electronic medical records were reviewed to determine if these patients developed CVD over 10 years since the index pregnancy. The end points were subsequent Hypertension, Myocardial Infarction, Cerebrovascular disease, Type 2 Diabetes Mellitus, and Thromboembolic events. The cohort was compared to controls delivered at the same institution. Results: The relative risk (RR) of subsequent type 2 diabetes mellitus was 1.93 [CI 1.00-3.75], if the exposed population was older than 35 at the time of the index pregnancy. The RR of subsequent hypertension was 2.21 [CI 1.3-3.77] in African Americans at any age of index pregnancy, regardless of exposure. When comparing all exposed population to our controls; there is an increased risk in our population of CVD with a RR of 1.58 (CI 1.12-.2.23), and a p value of 0.01. Conclusions: In our large, diverse, urban population, age or the presence of preeclampsia were associated with an increased risk for adverse CVD. These women may be appropriate for early CVD risk screening and intervention at younger ages than previously identified. Women with adverse pregnancy outcomes should be targeted for risk factor modification and prevention programs.

Pregnancy outcomes of women with and without a history of anorexia nervosa

2012 ◽  
Vol 42 (12) ◽  
pp. 2651-2660 ◽  
Author(s):  
J. M. Eagles ◽  
A. J. Lee ◽  
E. Amalraj Raja ◽  
H. R. Millar ◽  
S. Bhattacharya
Keyword(s):  
Anorexia Nervosa ◽  
Pregnancy Outcomes ◽  
Intrauterine Growth Restriction ◽  
Maternal Body Mass Index ◽  
Intrauterine Growth ◽  
North East ◽  
Increased Risk ◽  
History Of ◽  
Obstetric Services ◽  
Adverse Pregnancy

BackgroundWhen women have a history of anorexia nervosa (AN), the advice given about becoming pregnant, and about the management of pregnancies, has usually been cautious. This study compared the pregnancy outcomes of women with and without a history of AN.MethodWomen with a confirmed diagnosis of AN who had presented to psychiatric services in North East Scotland from 1965 to 2007 were identified. Those women with a pregnancy recorded in the Aberdeen Maternal and Neonatal Databank (AMND) were each matched by age, parity and year of delivery of their first baby with five women with no history of AN. Maternal and foetal outcomes were compared between these two groups of women. Comparisons were also made between the mothers with a history of AN and all other women in the AMND.ResultsA total of 134 women with a history of AN delivered 230 babies and the 670 matched women delivered 1144 babies. Mothers with AN delivered lighter babies but this difference did not persist after adjusting for maternal body mass index (BMI) in early pregnancy. Standardized birthweight (SBW) scores suggested that the AN mothers were more likely to produce babies with intrauterine growth restriction (IUGR) [relative risk (RR) 1.54, 95% confidence interval (CI) 1.11–2.13]. AN mothers were more likely to experience antepartum haemorrhage (RR 1.70, 95% CI 1.09–2.65).ConclusionsMothers with a history of AN are at increased risk of adverse pregnancy outcomes. The magnitude of these risks is relatively small and should be appraised holistically by psychiatric and obstetric services.

scholarly journals Coeliac disease and pregnancy outcomes

2011 ◽  
Vol 4 (3) ◽  
pp. 95-98 ◽  
Author(s):  
M M Butler ◽  
L C Kenny ◽  
F P McCarthy
Keyword(s):  
Coeliac Disease ◽  
Pregnancy Outcomes ◽  
Intrauterine Growth Restriction ◽  
Reproductive Medicine ◽  
Risk Groups ◽  
Intrauterine Growth ◽  
Increased Risk ◽  
Gluten Sensitive Enteropathy ◽  
Adverse Pregnancy ◽  
In Pregnancy

Coeliac disease is a gluten-sensitive enteropathy affecting up to 1% of the population. An accumulating body of evidence supports the association of coeliac disease with adverse pregnancy outcomes, including increased risk of miscarriage and intrauterine growth restriction. Reports differ regarding the extent and severity of these associations, in addition to the exact pathophysiology underlying these associations. Overall, coeliac disease is believed to be a significant condition in pregnancy and reproductive medicine with some advocating the screening of coeliac disease in all pregnant women or some specific high-risk groups.

scholarly journals Anticardiolipin Positivity Is Highly Associated With Intrauterine Growth Restriction in Women With Antiphospholipid Syndrome

2020 ◽  
Vol 26 ◽  
pp. 107602962097445
Author(s):  
Fangfang Xi ◽  
Yuliang Cai ◽  
Min Lv ◽  
Ying Jiang ◽  
Feifei Zhou ◽  
...  
Keyword(s):  
Pregnancy Outcomes ◽  
Intrauterine Growth Restriction ◽  
Low Molecular Weight Heparin ◽  
Low Dose ◽  
Low Molecular Weight ◽  
Intrauterine Growth ◽  
Factors Associated ◽  
Dose Aspirin ◽  
Low Dose Aspirin ◽  
Adverse Pregnancy

The purpose of our study was to evaluate pregnancy outcomes of women with antiphospholipid antibodies (aPL) positivity and assess risk factors associated with adverse pregnancy outcomes. Pregnant women with aPL positivity were enrolled prospectively in China from January 2017 to March 2020. Treatment of low-dose aspirin and low molecular weight heparin were given. Pregnancy outcomes and coagulation function were recorded and compared with normal pregnancies. Multivariable logistic regression was performed to identify risk factors associated to intrauterine growth restriction (IUGR). 270 pregnant women, including 44 diagnosed as Antiphospholipid syndrome (APS), 91 as non-criteria APS (NCAPS) and 135 normal cases as control, were enrolled in the study. The live birth rate in aPL carriers and APS group was 97% and 95.5%, respectively. Adverse pregnancy outcomes did not show significant difference between aPL carriers and normal pregnancies, and between APS and NCAPS, except for IUGR. The incidence of IUGR was significantly higher in aPL carriers than normal pregnancies, and in APS patients than NCAPS (P < 0.05). After controlling for age, in vitro fertilization (IVF), pregnancy losses related to APS and treatment, anticardiolipin (aCL) positivity was the only variable significantly associated with IUGR, with an adjusted odds ratio of 4.601 (95% CI, 1.205-17.573). Better pregnant outcomes of aPL positive women, include APS and NCAPS, were achieved in our study with treatment based on low-dose aspirin (LDA) plus low molecular weight heparin (LMWH). The incidence of IUGR was still higher in them, and aCL positivity was the only one risk factor associated with IUGR.

Abstract MP13: Prospective Associations of Prenatal Sedentary Behavior and Physical Activity Trajectories With Adverse Pregnancy Outcomes

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Bethany Barone Gibbs ◽  
Melissa A Jones ◽  
John M Jakicic ◽  
Arundhathi Jeyebalan ◽  
Kara M Whitaker ◽  
...  
Keyword(s):  
Physical Activity ◽  
Preterm Birth ◽  
Gestational Diabetes ◽  
Sedentary Behavior ◽  
Pregnancy Outcomes ◽  
Intrauterine Growth Restriction ◽  
Gestational Hypertension ◽  
Growth Restriction ◽  
Intrauterine Growth ◽  
Adverse Pregnancy

Background: Adverse pregnancy outcomes (APO) are risk factors for future cardiovascular disease. Though factors such as obesity increase the risk of APO, whether patterns of prenatal sedentary behavior (SED) or physical activity are associated with APO is unclear. Methods: This cohort study measured objective SED, steps, and moderate-vigorous intensity physical activity (MVPA) during each trimester of pregnancy. Women were instructed to wear two monitors for 7 d: a thigh-mounted activPAL3 micro to measure SED and steps, and an Actigraph GT3X on an elastic waist belt to measure MVPA. Women also completed a detailed wear log. Data were considered valid with ≥4 d of ≥10 hr of wear. Physician-diagnosed APO (gestational hypertension, preeclampsia, gestational diabetes, preterm birth, or intrauterine growth restriction) were abstracted from medical records by trained research personnel. Growth mixture modelling was used to construct separate SED, steps, and MVPA trajectories across pregnancy. Associations between trajectory groups and APO were evaluated using logistic regression with adjustment for prepregnancy BMI, race, education, and age. Results: Women (n=100) had mean (SD) age 31.2 (4.8) yr, pregnancy BMI 26.2 (6.8) kg/m 2 , and were 25% non-white. Trajectory analyses revealed three groups within each SED, steps, and MVPA (see Table). Nineteen women (19%) had at least one APO: gestational hypertension and/or preeclampsia (n=13), gestational diabetes (n=3), preterm birth (n=6), or intrauterine growth restriction (n=4). High vs. low SED trajectory was associated with more than 6-fold higher odds of APO. Medium and high vs. low steps trajectory was associated with lower odds of APO, but only medium vs. low trajectories were statistically different. MVPA trajectory was not associated with APO risk (see Table). Conclusion: Reducing SED and increasing daily steps, though not increasing MVPA, could be novel intervention targets for reducing APO and future cardiovascular risk in pregnant women.

scholarly journals Role of Inflammation in Virus Pathogenesis during Pregnancy

2020 ◽  
Vol 95 (2) ◽  
pp. e01381-19
Author(s):  
Anna Chudnovets ◽  
Jin Liu ◽  
Harish Narasimhan ◽  
Yang Liu ◽  
Irina Burd
Keyword(s):  
Immune Responses ◽  
Pregnancy Outcomes ◽  
Intrauterine Growth Restriction ◽  
Viral Infections ◽  
Critical Conditions ◽  
Viral Pathogens ◽  
Intrauterine Growth ◽  
Adverse Pregnancy ◽  
Asymptomatic Disease

ABSTRACTViral infections during pregnancy lead to a spectrum of maternal and fetal outcomes, ranging from asymptomatic disease to more critical conditions presenting with severe maternal morbidity, stillbirth, preterm birth, intrauterine growth restriction, and fetal congenital anomalies, either apparent at birth or later in life. In this article, we review the pathogenesis of several viral infections that are particularly relevant in the context of pregnancy and intrauterine inflammation. Understanding the diverse mechanisms employed by viral pathogens as well as the repertoire of immune responses induced in the mother may help to establish novel therapeutic options to attenuate changes in the maternal-fetal interface and prevent adverse pregnancy outcomes.

scholarly journals Prediction of Preeclampsia and Intrauterine Growth Restriction in Low-risk Pregnancies in East Avenue Medical Center using Uterine Artery Doppler Velocimetry

2019 ◽  
Vol 4 (2) ◽  
Keyword(s):  
Blood Pressure ◽  
Pregnancy Outcomes ◽  
Pregnancy Complications ◽  
Intrauterine Growth Restriction ◽  
Uterine Artery ◽  
Growth Restriction ◽  
Doppler Velocimetry ◽  
Uterine Artery Doppler ◽  
Intrauterine Growth ◽  
Adverse Pregnancy

Preeclampsia, which is defined as elevated blood pressure after 20 weeks of pregnancy in a woman whose blood pressure had been normal, remains the second most common cause of direct maternal deaths (0.83 per 100,000 cases) worldwide. At present, no effective prophylactic measures have been identified in the prevention of preeclampsia and other pregnancy complications such as intrauterine growth restriction. Therefore, proper antenatal care remains the most important part of prevention. Identifying each woman’s individualized risk can allow further antenatal surveillance to be directed to those women who are most likely to develop preeclampsia. Such care leads to early diagnosis and intervention, both in terms of maternal/ fetal monitoring and timing of delivery. In this study, uterine artery Doppler velocimetry in the mid-trimester will be analyzed, and its role in the prediction of later pregnancy complications (preeclampsia and intrauterine growth restriction) will be discussed. The aim of this study is to predict the risk for the development of adverse pregnancy outcomes on the basis of mid-trimester uterine artery Doppler velocimetry. Statistical analysis showed that preeclampsia occurred significantly more commonly in the group with an abnormal doppler result at 16-22 weeks of gestation, compared to pregnancies with normal doppler findings. That is 42.9% (3 out of 7) for abnormal doppler result versus 7.2% (2 out of 27) for those with normal doppler findings. However, none of the 34 evaluated cases developed intrauterine growth restriction. Abnormal uterine artery Doppler result at 16-22 weeks is associated with adverse pregnancy outcomes. In this study, it was well correlated with the development of preeclampsia. Hence, uterine artery Doppler can be used as a useful method for identifying high-risk pregnancies. Uterine artery pulsatility index (PI >1.45) can provide further information for the prediction of preeclampsia in order to conduct appropriate clinical interventions to avoid perinatal morbidity

Intrauterine Growth Restriction, Low Birth Weight, and Preterm Birth: Adverse Pregnancy Outcomes and Their Association With Maternal Periodontitis

2007 ◽  
Vol 78 (12) ◽  
pp. 2266-2276 ◽  
Author(s):  
Fernanda Mafra Siqueira ◽  
Luís Otávio Miranda Cota ◽  
José Eustáquio Costa ◽  
João Paulo Amaral Haddad ◽  
Ângela Maria Quintão Lana ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Pregnancy Outcomes ◽  
Intrauterine Growth Restriction ◽  
Adverse Pregnancy Outcomes ◽  
Growth Restriction ◽  
Intrauterine Growth ◽  
Adverse Pregnancy

scholarly journals Association Between Maternal Human Papillomavirus Infection and Adverse Pregnancy Outcomes: Systematic Review and Meta-Analysis

2020 ◽  
Vol 221 (12) ◽  
pp. 1925-1937 ◽  
Author(s):  
Joseph Niyibizi ◽  
Nadège Zanré ◽  
Marie-Hélène Mayrand ◽  
Helen Trottier
Keyword(s):  
Human Papillomavirus ◽  
Pregnancy Outcomes ◽  
Intrauterine Growth Restriction ◽  
Meta Analysis ◽  
Adverse Pregnancy Outcomes ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Intrauterine Growth ◽  
Preterm Premature Rupture ◽  
Adverse Pregnancy

Abstract Background Experimental studies provide evidence of the harmful effect of human papillomavirus (HPV) infection on pregnancy, but observational studies are inconclusive. We systematically assessed the association between HPV and adverse pregnancy outcomes. Methods We searched electronic databases up to December 1, 2019. We included observational studies on the association between HPV and adverse pregnancy outcomes. We conducted a random-effect meta-analysis for each outcome and assessed heterogeneity between studies. Results From 3034 citations, we included 38 studies and quantitatively synthesized 36 studies. Human papillomavirus was significantly associated with preterm birth (age-adjusted odds ratio [aOR], 1.50; 95% confidence interval [CI], 1.19–1.88), preterm premature rupture of membranes (aOR, 1.96; 95% CI, 1.11–3.45), premature rupture of membranes (aOR, 1.42; 95% CI, 1.08–1.86), intrauterine growth restriction (aOR, 1.17; 95% CI, 1.01–1.37), low birth weight (aOR, 1.91; 95% CI, 1.33–2.76), and fetal death (aOR, 2.23; 95% CI, 1.14–4.37). No significant association was found for spontaneous abortion (aOR, 1.14; 95% CI, 0.40–3.22) and pregnancy-induced hypertensive disorders (aOR, 1.24; 95% CI, 0.80–1.92). Most of the studies were of moderate or low quality, and substantial between-studies heterogeneity remained unexplained. Conclusions We found a consistent and significant association between HPV and preterm birth and preterm premature rupture of membranes. Human papillomavirus may also be associated with intrauterine growth restriction, low birth weight, and fetal death, but findings are limited by suboptimal control of biases.

scholarly journals Maternal HPV Infection: Effects on Pregnancy Outcome

Viruses ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2455
Author(s):  
Carmen Elena Condrat ◽  
Lidia Filip ◽  
Mirela Gherghe ◽  
Dragos Cretoiu ◽  
Nicolae Suciu
Keyword(s):  
Pregnancy Outcomes ◽  
Intrauterine Growth Restriction ◽  
Child Survival ◽  
Harmful Effect ◽  
Hpv Infection ◽  
Transmitted Infection ◽  
Papilloma Virus ◽  
Sexually Transmitted ◽  
Increased Risk ◽  
Adverse Pregnancy

The human papilloma virus (HPV) infection, caused by a ubiquitous virus typically transmitted through the direct contact of infected organs, either through the skin or mucosa, is the most common sexually transmitted infection, placing young women at a high risk of contracting it. Although the vast majority of cases spontaneously clear within 1–2 years, persistent HPV infection remains a serious concern, as it has repeatedly been linked to the development of multiple malignancies, including cervical, anogenital, and oropharyngeal cancers. Additionally, more recent data suggest a harmful effect of HPV infection on pregnancy. As the maternal hormonal environment and immune system undergo significant changes during pregnancy, the persistence of HPV is arguably favored. Various studies have reported an increased risk of adverse pregnancy outcomes among HPV-positive women, with the clinical impact encompassing a range of conditions, including preterm birth, miscarriage, pregnancy-induced hypertensive disorders (PIHD), intrauterine growth restriction (IUGR), low birth weight, the premature rupture of membranes (PROM), and fetal death. Therefore, understanding the mechanisms employed by HPV that negatively impact pregnancy and assessing potential approaches to counteract them would be of interest in the quest to optimize pregnancy outcomes and improve child survival and health.

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