Early or Late Pregnancy Loss and Development of Clinical Cardiovascular Disease Risk Factors: a Prospective Cohort Study

Overview

Journal BJOG

Specialty Gynecology & Obstetrics

Date 2018 Aug 26

PMID 30144277

Citations 28

Authors

J Horn

L J Tanz

J J Stuart

A R Markovitz

G Skurnik

E B Rimm

S A Missmer

J W Rich-Edwards

Affiliations

Soon will be listed here.

Abstract

Objective: To assess the association between the outcome of a woman's first pregnancy and risk of clinical cardiovascular disease risk factors.

Design: Prospective cohort study.

Setting And Population: Nurses' Health Study II.

Methods: Multivariable-adjusted Cox proportional hazards models were used to compute hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between first pregnancy outcome and hypertension, type 2 diabetes, and hypercholesterolemia.

Main Outcome Measures: Hypertension, type 2 diabetes, and hypercholesterolemia.

Results: Compared to women who reported a singleton live first birth, women with early spontaneous abortion (<12 weeks) had a greater rate of type 2 diabetes (HR: 1.20; 95% CI: 1.07-1.34) and hypercholesterolemia (HR: 1.06; 95% CI: 1.02-1.10), and a marginally increased rate of hypertension (HR: 1.05, 95% CI: 1.00-1.11). Late spontaneous abortion (12-19 weeks) was associated with an increased rate of type 2 diabetes (HR: 1.38; 95% CI: 1.14-1.65), hypercholesterolemia (HR: 1.11; 95% CI: 1.03-1.19), and hypertension (HR: 1.15; 95% CI: 1.05-1.25). The rates of type 2 diabetes (HR: 1.45; 95% CI: 1.13-1.87) and hypertension (HR: 1.15; 95% CI: 1.01-1.30) were higher in women who delivered stillbirth. In contrast, women whose first pregnancy ended in an induced abortion had lower rates of hypertension (HR: 0.87; 95% CI: 0.84-0.91) and type 2 diabetes (HR: 0.89; 95% CI: 0.79-0.99) than women with a singleton live birth.

Conclusions: Several types of pregnancy loss were associated with an increased rate of hypertension, type 2 diabetes, and hypercholesterolemia, which may provide novel insight into the pathways through which pregnancy outcomes and CVD are linked.

Tweetable Abstract: Pregnancy loss is associated with later maternal risk of hypertension, type 2 diabetes, and hypercholesterolemia.

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PMID: 38813443 PMC: 11133813. DOI: 10.1016/j.eclinm.2024.102560.

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