Combinations of Pregnancy Complications May Predict CVD Death
(HealthDay News) — Combinations of pregnancy complications can predict high risk of cardiovascular disease (CVD) death, according to a study published online September 21 in Circulation.
Piera M. Cirillo, MPH, and Barbara A. Cohn, PhD, from the Public Health Institute in Berkeley, CA, and colleagues examined pregnancy events (1959–1967) and subsequent CVD death in 14,062 women from the Child Health and Development Studies. The women were a median age of 26 years at enrollment and were followed through 2011 (median age, 66 years).
The researchers found that CVD death was predicted by pre-existing hypertension, glycosuria, late-onset preeclampsia (after week 34), and hemoglobin decline over the second and third trimesters (hazard ratios, 3.5, 4.2, 2.0, and 1.7, respectively). Premature CVD death was significantly predicted by delivery of a small-for-gestation or preterm infant and early onset preeclampsia (by week 34) (P<0.05 for age dependence). The combination of preterm birth with hemorrhage, gestational hypertension, or pre-existing hypertension correlated with a four- to seven-fold elevated CVD death risk. The risk was nearly six-fold for preeclampsia in conjunction with preexisting hypertension, compared with a four-fold risk for preexisting hypertension alone.
"Obstetricians serve as primary care physicians for many young women and can readily use these complications to identify high-risk women to implement early prevention," the authors write.