scholarly journals Do self-reported pregnancy complications add to risk evaluation in older women with established cardiovascular disease?

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Elin Täufer Cederlöf ◽  
Nina Johnston ◽  
Jerzy Leppert ◽  
Pär Hedberg ◽  
Bertil Lindahl ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Birth Weight ◽  
Older Women ◽  
Pregnancy Complications ◽  
Risk Evaluation ◽  
Gestational Hypertension ◽  
Late Pregnancy ◽  
High Birth Weight ◽  
Established Risk Factor ◽  
Vascular Beds

Abstract Background In postmenopausal women with established cardiovascular disease (CVD), it is unknown whether a history of pregnancy complications are related to multisite artery disease (MSAD), defined as atherosclerotic lesions in at least two major vascular beds. Pregnancy complications are an established risk factor for CVD. This study aimed to investigate the frequency of pregnancy complications and their association to specific atherosclerotic manifestations and prediction of MSAD in older women with and without CVD. Methods In total, 556 women were invited to participate in the study. Of these women 307 reported former pregnancy from a cohort of women with (n = 233) and without CVD (n = 74). The self-reported frequency of pregnancy complications were surveyed retrospectively by a questionnaire that included miscarriage, subfertility, gestational hypertension (GHT) and/or preeclampsia (PE), low birth weight, preterm birth, bleeding in late pregnancy, gestational diabetes mellitus and high birth weight. Three vascular beds were examined, the peripheral, carotid and coronary arteries. Results The mean age was 67.5 (SD 9.5) years. GHT and/or PE tended to be more common, but not significant, in women with CVD than in women without (20.3% vs 10.8%, p = 0.066). Among women with GHT and/or PE, hypertension later in life were more frequent than in women without (66.7% vs 47.4%, p = 0.010). GHT and/or PE were not associated with specific atherosclerotic manifestations or prediction of MSAD. Conclusions In older women with established CVD, pregnancy complications was not associated to specific atherosclerotic manifestations and may not provide additional value to the risk evaluation for MSAD.

scholarly journals Parity and Cardiovascular Disease Risk among Older Women: How Do Pregnancy Complications Mediate the Association?

2008 ◽  
Vol 18 (12) ◽  
pp. 873-879 ◽  
Author(s):  
Janet M. Catov ◽  
Anne B. Newman ◽  
Kim Sutton-Tyrrell ◽  
Tamara B. Harris ◽  
Francis Tylavsky ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Older Women ◽  
Pregnancy Complications ◽  
Disease Risk ◽  
Cardiovascular Disease Risk

Abstract MP68: Association of Clinical and Subclinical Blood Pressure Elevation During Pregnancy With Maternal Health and Risk of Neonatal Low Birth Weight

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Jie Hu ◽  
Jun Li ◽  
Yang Peng ◽  
Yuanyuan Li
Keyword(s):  
Blood Pressure ◽  
Birth Weight ◽  
Maternal Health ◽  
Low Birth Weight ◽  
Gestational Hypertension ◽  
Late Pregnancy ◽  
Blood Pressure Elevation ◽  
Pressure Elevation ◽  
Elevated Liver Enzymes ◽  
Increased Risk

Introduction: Gestational hypertension is a leading cause of maternal mortality and fetal growth restriction (FGR). However, elevated maternal blood pressure at which trimester contributes to FGR is unknown, and whether gestational prehypertension (a systolic blood pressure [SBP] of 120 - 139 mmHg or a diastolic blood pressure [DBP] of 80 - 89 mmHg) is related with FGR and maternal health is not fully studied. Methods: We analyzed the relation of elevated gestational blood pressure with risk of neonatal low-birth-weight (LBW, birth weight < 2,500 g) and maternal health throughout pregnancy in 21,620 women from a birth cohort in Wuhan, China. Maternal health indicators, including SBP and DBP, were clinically measured during up to 22 antenatal visits. LBW were acquired from medical records. Linear mixed models were used to evaluate the relations of maternal SBP and DBP with LBW. Logistic regressions were used to assess the associations of SBP and DBP in late pregnancy (38.3 weeks) with LBW. Linear regressions were used to evaluate the association of prehypertension/hypertension with indicators of maternal health. Results: Gestational blood pressure increases throughout pregnancy, but a significant elevation of SBP and DBP between 15 and 25 gestational weeks were only observed for women who later delivered LBW newborns. High gestational SBP (≥ 140 mmHg) or DBP (≥ 90 mmHg) was associated with a 220% or 98% higher risk of LBW ( P < 0.03). Notably, preclinical high SBP (120 - 139 mmHg) was also associated with a 40% higher risk of LBW ( P = 0.036). At late pregnancy, elevated gestational SBP and DBP were associated with elevated liver enzymes, blood urea nitrogen, creatinine, and uric acid levels, and decreased activated partial thromboplastin time and prothrombin time. Conclusions: A fast blood pressure elevation in the second trimester may relate with increased risk of LBW. Pregnancy prehypertension was associated with not only LBW risk, but also impaired maternal liver, kidney, and coagulation functions.

scholarly journals Pregnancy Complications and Risk of Cardiovascular Disease Later in Life: A Nationwide Cohort Study

2022 ◽  
Author(s):  
Elin Täufer Cederlöf ◽  
Maria Lundgren ◽  
Bertil Lindahl ◽  
Christina Christersson
Keyword(s):  
Cardiovascular Disease ◽  
Cohort Study ◽  
Preterm Birth ◽  
Cardiovascular Mortality ◽  
Pregnancy Complications ◽  
Gestational Hypertension ◽  
Medical Birth Register ◽  
Swedish Medical ◽  
Artery Disease ◽  
Cox Proportional Hazard Regression

Background The aim of this study was to investigate the associations between pregnancy complications and cardiovascular mortality and hospitalizations of cardiovascular disease (CVD) after adjustment for major confounding. Methods and Results In a nationwide register‐based cohort study, women with singleton births between 1973 and 2014 were included from the Swedish Medical Birth Register. Outcomes of mortality and hospitalizations of CVD were collected from the Cause of Death Register and the National Inpatient Register. The cohort was followed from the date of the first delivery until death or end of follow‐up, whichever occurred first. The pregnancy complications studied were preeclampsia or eclampsia, gestational hypertension, gestational diabetes, preterm birth, small for gestational age, and stillbirth. Among the 2 134 239 women (mean age at first pregnancy, 27.0 [SD, 5.1] and mean parity 1.96 [SD, 0.9]), 19.1% (N=407 597) had 1 of the studied pregnancy complications. All pregnancy complications were associated with all‐cause and cardiovascular mortality and hospitalization for CVD (ischemic heart disease, ischemic stroke, and peripheral artery disease) after adjustment for major confounding in a Cox proportional hazard regression model. The adjusted hazard ratio for cardiovascular mortality was 1.84 (95% CI, 1.38–2.44) for preterm birth and 3.14 (95% CI, 1.81–5.44) for stillbirth. Conclusions In this large cohort study, pregnancy complications were associated with all‐cause mortality, cardiovascular mortality, and hospitalizations for CVD, also after adjusting for confounding, including overweight, smoking, and comorbidities. The study highlights that less established pregnancy complications such as preterm birth and stillbirth are also associated with cardiovascular mortality and CVD.

scholarly journals Risk prediction of maternal cardiovascular disease one year after hypertensive pregnancy complications or gestational diabetes mellitus

2019 ◽  
Vol 27 (12) ◽  
pp. 1273-1283 ◽  
Author(s):  
Kjartan Moe ◽  
Meryam Sugulle ◽  
Ralf Dechend ◽  
Anne Cathrine Staff
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnancy Complications ◽  
Disease Risk ◽  
Gestational Hypertension ◽  
Cardiovascular Disease Risk ◽  
Risk Scores ◽  
One Year

Background Previous preeclampsia, gestational hypertension and gestational diabetes mellitus show a firm epidemiological association to maternal cardiovascular disease risk. Cardiovascular disease risk assessment is recommended in women after these pregnancy complications, but not offered in most countries. We therefore wanted to evaluate the applicability of currently recommended cardiovascular disease risk scores for women one-year postpartum of such pregnancy complications. Design and methods We tested applicability of three scoring systems, the Atherosclerotic Cardiovascular Disease (ASCVD) score, the Joint British Societies for the Prevention of Cardiovascular Disease (JBS3) score and Framingham 30 year Risk Score-Cardiovascular Disease (FRS-CVD) in 235 women one-year postpartum (controls: 94, gestational hypertension: 35, preeclampsia: 81, gestational diabetes mellitus: 25). Statistical analysis was performed with Mann–Whitney U test for continuous and Fisher’s mid-corrected p and Pearson’s r for dichotomous variables. A value of p < 0.050 was considered significant. Results Most women (87.7%) were below 40 years of age, rendering 10-year risk estimations recommended by American and European societies inapplicable. FRS-CVD could be assessed in all women. Significantly fewer could be assessed by the ASCVD (81.5%) and JBS3 (91.6%). All scoring systems showed small, but significant increases in risk scores for one or more of the pregnancy complication groups, but none at the risk magnitude for cardiovascular disease shown in epidemiological studies. Conclusion We demonstrate that ASCVD, JBS3 and FRS-CVD are inadequate in assessing cardiovascular disease risk one-year postpartum. We suggest that pregnancy complications need to be considered separately when evaluating maternal cardiovascular disease risk and need for postpartum follow-up.

scholarly journals Maternal and cord blood prolactin level and pregnancy complications

2019 ◽  
Vol 35 (4) ◽  
Author(s):  
Zainab M. Alawad ◽  
Hanan L. Al-Omary
Keyword(s):  
Birth Weight ◽  
Cord Blood ◽  
Pregnancy Complications ◽  
Prolactin Level ◽  
Gestational Hypertension ◽  
Normal Pregnancy ◽  
Maternal Blood ◽  
Preterm Neonates ◽  
Creative Commons ◽  
Significant Difference

Objectives: To explore the correlation between maternal and cord blood prolactin, the correlation between cord prolactin and birth weight, and to compare cord blood prolactin in new-borns of women with normal pregnancy and women with pregnancy complications namely; gestational hypertension, gestational diabetes and preterm labour.Methods: This study was performed from September to December 2018. Thirty-two women, delivered at Baghdad teaching hospital, and their newborns (32) were included. Maternal blood (5 ml) was taken before labour and cord blood (5 ml) was collected after placenta expulsion. Maternal and cord blood prolactin were analysed using fluorescence immunoassay. Results: Cord blood prolactin was higher in babies born to hypertensive women (405.28±77.52 ng/ml) than normal pregnancy women (244.80±60.80 ng/ml), P=0.000. Also, cord prolactin in gestational hypertension group was significantly higher than diabetic (P=0.006) and preterm labour (P=0.000) groups. No significant difference was noticed in cord blood prolactin in newborns of diabetic and normal pregnancy women (299.28±37.01, 244.80±60.80 ng/ml respectively, P=0.053). Preterm babies had lower cord prolactin (204.57±22.90 ng/ml) than normal pregnancy babies (244.80±60.80 ng/ml), however the difference was non-significant, P=0.118. Positive correlation was found between cord and maternal prolactin (P=0.000) and between cord prolactin and birth weight (P=0.018). Conclusion: Cord blood prolactin is high in newborns of hypertensive women, low in preterm neonates. Diabetes has no effect on cord prolactin level. doi: https://doi.org/10.12669/pjms.35.4.558 How to cite this:Alawad ZM, Al-Omary HL. Maternal and cord blood prolactin level and pregnancy complications. Pak J Med Sci. 2019;35(4):---------. doi: https://doi.org/10.12669/pjms.35.4.558 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract P303: High Birth Weight Modifies Estimated Effects of Physical Activity on Cardiometabolic Health in Females

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Thomas L Jeanne ◽  
Rebecca Sacks ◽  
Thuan Nguyen ◽  
Lynne Messer ◽  
Janne Boone-Heinonen
Keyword(s):  
Physical Activity ◽  
Cardiovascular Disease ◽  
Birth Weight ◽  
Vigorous Physical Activity ◽  
Early Adulthood ◽  
Cardiometabolic Health ◽  
High Birth Weight ◽  
Adult Health ◽  
Cvd Risk ◽  
Adolescent Physical Activity

Background: Birth weight and physical activity are independently associated with cardiometabolic health outcomes. Low or high birth weight are indicators of adverse prenatal development, which may alter physiological response to physical activity later in life. However, few studies have explored the potential interaction between birth weight and physical activity as determinants of cardiometabolic health. Objective: We evaluated the hypothesis that high or low birth weight modifies the association of early life physical activity with cardiovascular disease or diabetes later in life. Methods: We analyzed data from the National Longitudinal Study of Adolescent and Adult Health (Add Health), a nationally representative cohort of US adolescents followed into adulthood ( n =20,745) with four data collection waves between 1994 and 2008. Outcomes were assessed in early adulthood: (1) predicted 30-year cardiovascular disease (CVD) risk, computed by a validated algorithm based on objective measures, and (2) prevalent pre-diabetes and diabetes. Using gender-stratified multivariable regression on multiply imputed data, we modeled (1) log-transformed 30-year CVD risk (linear regression) and (2) prevalent pre-diabetes and diabetes (PDM/DM; ordinal regression) each as a function of birth weight (low, normal, high; LBW, NBW, HBW) and self-reported moderate-to-vigorous physical activity frequency (MVPA) in adolescence and young adulthood, adjusting for age, smoking, and sociodemographic factors. Results: A greater proportion of women born at LBW had diabetes than NBW and HBW women (10.8% versus 5.9% and 5.4%, respectively). In adjusted analyses, MVPA in adolescence (MVPA1) and early adulthood (MVPA3) were not significantly associated with predicted CVD risk and prevalent pre-diabetes diabetes in men or women overall. However, greater MVPA1 was associated with lower predicted 30-year CVD risk in HBW females (estimated effect coefficient -0.02 [95% CI: -0.03, -0.005, p =0.02], p =0.05 for HBWхMVPA1 interaction), and the HBWхMVPA1 interaction on PDM/DM approached significance in females ( p =0.12). In females and males of LBW or NBW, MVPA1 was not significantly associated with predicted 30-year CVD risk or PDM/DM and LBWхMVPA1 interactions were not significant. Conclusions: Greater adolescent physical activity was most strongly associated with lower 30-year CVD risk in young women born at HBW. A similar association with prevalent DM/PDM approached significance, with greater adolescent physical activity most strongly associated in HBW women. Females born at HBW may be especially sensitive to the effects of physical activity on reducing risk of cardiometabolic disease later in life, with important implications for disease prevention and health policy.

scholarly journals Influence of vitamin D serum concentration, prenatal care and social determinants on birth weight: a northeastern Brazilian cohort study

2019 ◽  
Vol 122 (03) ◽  
pp. 284-292 ◽  
Author(s):  
Marcos Pereira-Santos ◽  
Gisele Queiroz Carvalho ◽  
Djanilson Barbosa dos Santos ◽  
Ana Marlucia Oliveira
Keyword(s):  
Vitamin D ◽  
Birth Weight ◽  
Prenatal Care ◽  
Serum Concentration ◽  
Pregnant Women ◽  
Social Determinants ◽  
Maternal Education ◽  
Late Onset ◽  
High Birth Weight ◽  
Maternal Vitamin

AbstractThe relationship among social determinants, vitamin D serum concentration and the health and nutrition conditions is an important issue in the healthcare of pregnant women and newborns. Thus, the present study analyses how vitamin D, prenatal monitoring and social determinants are associated with birth weight. The cohort comprised 329 pregnant women, up to 34 weeks gestational age at the time of admission, who were receiving care through the prenatal services of Family Health Units. Structural equation modelling was used in the statistical analysis. The mean birth weight was 3340 (sd 0·545) g. Each nmol increase in maternal vitamin D serum concentration was associated with an increase in birth weight of 3·06 g. Prenatal healthcare with fewer appointments (β −41·49 g, 95 % CI −79·27, −3·71) and late onset of care in the second trimester or third trimester (β −39·24 g, 95 % CI −73·31, −5·16) favoured decreased birth weight. In addition, low socio-economic class and the practice of Afro-Brazilian religions showed a direct association with high vitamin D serum concentrations and an indirect association with high birth weight, respectively. High gestational BMI (β 23·84, 95 % CI 4·37, 43·31), maternal education level (β 24·52 g, 95 % CI 1·82, 47·23) and length of gestation (β 79·71, 95 % CI 52·81; 106·6) resulted in high birth weight. In conclusion, maternal vitamin D serum concentration, social determinants and prenatal care, evaluated in the context of primary healthcare, directly determined birth weight.

scholarly journals Women with a History of Recurrent Pregnancy Loss Are a High-Risk Population for Adverse Obstetrical Outcome: A Retrospective Cohort Study

2021 ◽  
Vol 10 (2) ◽  
pp. 179
Author(s):  
Emma Rasmark Roepke ◽  
Ole Bjarne Christiansen ◽  
Karin Källén ◽  
Stefan R. Hansson
Keyword(s):  
Cohort Study ◽  
Preterm Birth ◽  
Pregnancy Complications ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Placental Abruption ◽  
Late Pregnancy ◽  
High Risk Population ◽  
Risk Population ◽  
Increased Risk

Recurrent pregnancy loss (RPL), defined as three or more consecutive miscarriages, is hypothesized to share some of the same pathogenic factors as placenta-associated disorders. It has been hypothesized that a defect implantation causes pregnancy loss, while a partially impaired implantation may lead to late pregnancy complications. The aim of this retrospective register-based cohort study was to study the association between RPL and such disorders including pre-eclampsia, stillbirth, small for gestational age (SGA) birth, preterm birth and placental abruption. Women registered with childbirth(s) in the Swedish Medical Birth Register (MFR) were included in the cohort. Pregnancies of women diagnosed with RPL (exposed) in the National Patient Register (NPR), were compared with pregnancies of women without RPL (unexposed/reference). Obstetrical outcomes, in the first pregnancy subsequent to the diagnosis of RPL (n = 4971), were compared with outcomes in reference-pregnancies (n = 57,410). Associations between RPL and placental dysfunctional disorders were estimated by odds ratios (AORs) adjusting for confounders, with logistic regression. RPL women had an increased risk for pre-eclampsia (AOR 1.45; 95% CI; 1.24–1.69), stillbirth <37 gestational weeks (GWs) (AOR 1.92; 95% CI; 1.22–3.02), SGA birth (AOR 1.97; 95% CI; 1.42–2.74), preterm birth (AOR 1.46; 95% CI; 1.20–1.77), and placental abruption <37 GWs (AOR 2.47; 95% CI; 1.62–3.76) compared with pregnancies by women without RPL. Women with RPL had an increased risk of pregnancy complications associated with placental dysfunction. This risk population is, therefore, in need of improved antenatal surveillance.

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