-
Tytuł:
-
Association of Adverse Pregnancy Outcomes With Risk of Atherosclerotic Cardiovascular Disease in Postmenopausal Women.
-
Autorzy:
-
Søndergaard MM; Aalborg University School of Medicine and Health, Aalborg, Denmark.
Hlatky MA; Stanford University School of Medicine, Stanford, California.
Stefanick ML; Stanford University School of Medicine, Stanford, California.
Vittinghoff E; UCSF School of Medicine, University of California, San Francisco.
Nah G; UCSF School of Medicine, University of California, San Francisco.
Allison M; UC San Diego School of Medicine, University of California, San Diego.
Gemmill A; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Van Horn L; Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Park K; University of Florida School of Medicine, Gainesville.
Salmoirago-Blotcher E; Brown University Alpert School of Medicine, Providence, Rhode Island.
Sattari M; University of Florida School of Medicine, Gainesville.
Sealy-Jefferson S; Ohio State University College of Public Health, Columbus.
Shadyab AH; UC San Diego School of Medicine, University of California, San Diego.
Valdiviezo C; MedStar Health, Washington, DC.
Manson JE; Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Parikh NI; UCSF School of Medicine, University of California, San Francisco.
-
Źródło:
-
JAMA cardiology [JAMA Cardiol] 2020 Dec 01; Vol. 5 (12), pp. 1390-1398.
-
Typ publikacji:
-
Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
-
Język:
-
English
-
Imprint Name(s):
-
Original Publication: [Chicago, Illinois] : American Medical Association, [2016]-
-
MeSH Terms:
-
Pregnancy Outcome*
Atherosclerosis/*epidemiology
Pregnancy Complications, Cardiovascular/*epidemiology
Female ; Humans ; Middle Aged ; Postmenopause ; Pregnancy ; Prospective Studies ; Risk Assessment ; Risk Factors ; Self Report
-
Grant Information:
-
R01 HL139844 United States HL NHLBI NIH HHS; HHSN268201100046C United States HL NHLBI NIH HHS; HHSN268201100001C United States WH WHI NIH HHS; HHSN268201100002C United States WH WHI NIH HHS; HHSN268201100003C United States WH WHI NIH HHS; HHSN268201100004C United States WH WHI NIH HHS
-
Entry Date(s):
-
Date Created: 20200916 Date Completed: 20220113 Latest Revision: 20220113
-
Update Code:
-
20240104
-
PubMed Central ID:
-
PMC7495331
-
DOI:
-
10.1001/jamacardio.2020.4097
-
PMID:
-
32936228
-
Importance: Atherosclerotic cardiovascular disease (ASCVD) may have unique risk factors in women. Most women have a history of pregnancy; common adverse pregnancy outcomes (APOs) appear to be associated with ASCVD, but prior studies have limitations.
Objective: To assess whether APOs are associated with increased ASCVD risk independently of traditional risk factors.
Design, Setting, and Participants: The APO history among participants in the Women's Health Initiative, a large multiethnic cohort of postmenopausal women, was assessed. The associations of 5 self-reported APOs (gestational diabetes, hypertensive disorders of pregnancy, low birth weight [ie, birth weight less than 2.49 kg], high birth weight [ie, birth weight greater than 4.08 kg], and preterm delivery by 3 weeks or more) with ASCVD were analyzed, adjusting for traditional ASCVD risk factors. Data were collected and analyzed in 2017.
Exposures: APOs (gestational diabetes, hypertensive disorders of pregnancy, low birth weight, high birth weight, and preterm delivery).
Main Outcomes and Measures: Adjudicated ASCVD.
Results: A total of 48 113 Women's Health Initiative participants responded to the survey; the median (interquartile range) age at time of enrollment was 60.0 (55.0-64.0) years. A total of 13 482 participants (28.8%) reported 1 or more APOs. Atherosclerotic cardiovascular disease was more frequent in women who reported an APO compared with those without APOs (1028 of 13 482 [7.6%] vs 1758 of 30 522 [5.8%]). Each APO, analyzed separately, was significantly associated with ASCVD, and gestational diabetes, hypertensive disorders of pregnancy, low birth weight, and preterm delivery remained significant after adjustment for traditional ASCVD risk factors. When all APOs were analyzed together, hypertensive disorders of pregnancy (odds ratio, 1.27; 95% CI, 1.15-1.40) and low birth weight (odds ratio, 1.12; 95% CI, 1.00-1.26) remained independently associated with ASCVD. All findings were materially unchanged by additional adjustment for parity, body mass index, and socioeconomic factors.
Conclusions and Relevance: In this large multiethnic cohort of women, hypertensive disorders of pregnancy and low birth weight were independently associated with ASCVD after adjustment for risk factors and other APOs.
Comment in: JAMA Cardiol. 2020 Dec 1;5(12):1398-1400. (PMID: 32936208)
