Sonia M Grandi1,2, Kristian B Filion1,2,3, Sarah Yoon1,2, Henok T Ayele1,2, Carla M Doyle1,2, Jennifer A Hutcheon4, Graeme N Smith5, Genevieve C Gore6, Joel G Ray7, Kara Nerenberg8, Robert W Platt1,2,9. 1. Department of Epidemiology, Biostatisticcs and Occupational Health, McGill University, Montreal, QC, Canada (S.G., K.F., S.Y., H.A., C.D., R.P.). 2. Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada (S.G., K.F., S.Y., H.A., C.D., R.P.). 3. Department of Medicine, McGill University, Montreal, QC, Canada (K.F.). 4. Department of Obstetrics and Gynaecology, Faculty of Medicine, University of British Columbia, Canada (J.H.). 5. Department of Obstetrics and Gynaecology, School of Medicine, Queen's University, Kingston, ON, Canada (G.S.). 6. Schulich Library of Science and Engineering, McGill University, Montreal, QC, Canada (G.G.). 7. Department of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, ON, Canada (J.R.). 8. University of Calgary, Department of Medicine, Cumming School of Medicine, AB, Canada (K.N.). 9. McGill University Health Center Research Institute and Department of Pediatrics, McGill University, Montreal, QC, Canada (R.P.).
Abstract
BACKGROUND: Women with a history of certain pregnancy complications are at higher risk for cardiovascular (CVD) disease. However, most clinical guidelines only recommend postpartum follow-up of those with a history of preeclampsia, gestational diabetes mellitus, or preterm birth. This systematic review was undertaken to determine if there is an association between a broader array of pregnancy complications and the future risk of CVD. METHODS: We systematically searched PubMed, MEDLINE and EMBASE (via Ovid), CINAHL, and the Cochrane Library from inception to September 22, 2017, for observational studies of the association between the hypertensive disorders of pregnancy, placental abruption, preterm birth, gestational diabetes mellitus, low birth weight, small-for-gestational-age birth, stillbirth, and miscarriage and subsequent CVD. Likelihood ratio meta-analyses were performed to generate pooled odds ratios (OR) and 95% intrinsic confidence intervals (ICI). RESULTS: Our systematic review included 84 studies (28 993 438 patients). Sample sizes varied from 250 to 2 000 000, with a median follow-up of 7.5 years postpartum. The risk of CVD was highest in women with gestational hypertension (OR 1.7; 95% ICI, 1.3-2.2), preeclampsia (OR 2.7; 95% ICI, 2.5-3.0), placental abruption (OR 1.8; 95% ICI, 1.4-2.3), preterm birth (OR 1.6; 95% ICI, 1.4-1.9), gestational diabetes mellitus (OR 1.7; 95% ICI, 1.1-2.5), and stillbirth (OR 1.5; 95% ICI, 1.1-2.1). A consistent trend was seen for low birth weight and small-for-gestational-age birth weight but not for miscarriage. CONCLUSIONS: Women with a broader array of pregnancy complications, including placental abruption and stillbirth, are at increased risk of future CVD. The findings support the need for assessment and risk factor management beyond the postpartum period.
BACKGROUND:Women with a history of certain pregnancy complications are at higher risk for cardiovascular (CVD) disease. However, most clinical guidelines only recommend postpartum follow-up of those with a history of preeclampsia, gestational diabetes mellitus, or preterm birth. This systematic review was undertaken to determine if there is an association between a broader array of pregnancy complications and the future risk of CVD. METHODS: We systematically searched PubMed, MEDLINE and EMBASE (via Ovid), CINAHL, and the Cochrane Library from inception to September 22, 2017, for observational studies of the association between the hypertensive disorders of pregnancy, placental abruption, preterm birth, gestational diabetes mellitus, low birth weight, small-for-gestational-age birth, stillbirth, and miscarriage and subsequent CVD. Likelihood ratio meta-analyses were performed to generate pooled odds ratios (OR) and 95% intrinsic confidence intervals (ICI). RESULTS: Our systematic review included 84 studies (28 993 438 patients). Sample sizes varied from 250 to 2 000 000, with a median follow-up of 7.5 years postpartum. The risk of CVD was highest in women with gestational hypertension (OR 1.7; 95% ICI, 1.3-2.2), preeclampsia (OR 2.7; 95% ICI, 2.5-3.0), placental abruption (OR 1.8; 95% ICI, 1.4-2.3), preterm birth (OR 1.6; 95% ICI, 1.4-1.9), gestational diabetes mellitus (OR 1.7; 95% ICI, 1.1-2.5), and stillbirth (OR 1.5; 95% ICI, 1.1-2.1). A consistent trend was seen for low birth weight and small-for-gestational-age birth weight but not for miscarriage. CONCLUSIONS:Women with a broader array of pregnancy complications, including placental abruption and stillbirth, are at increased risk of future CVD. The findings support the need for assessment and risk factor management beyond the postpartum period.
Authors: Laura Ormesher; Suzanne Higson; Matthew Luckie; Stephen A Roberts; Heather Glossop; Andrew Trafford; Elizabeth Cottrell; Edward D Johnstone; Jenny E Myers Journal: Hypertension Date: 2020-10-05 Impact factor: 10.190
Authors: Michael C Honigberg; Hilde Kristin Refvik Riise; Anne Kjersti Daltveit; Grethe S Tell; Gerhard Sulo; Jannicke Igland; Kari Klungsøyr; Nandita S Scott; Malissa J Wood; Pradeep Natarajan; Janet W Rich-Edwards Journal: Hypertension Date: 2020-08-24 Impact factor: 10.190
Authors: Ellen W Seely; Ann C Celi; Jaimie Chausmer; Cornelia Graves; Sarah Kilpatrick; Jacinda M Nicklas; Mary L Rosser; Kathryn M Rexrode; Jennifer J Stuart; Eleni Tsigas; Jennifer Voelker; Carolyn Zelop; Janet W Rich-Edwards Journal: J Womens Health (Larchmt) Date: 2020-09-28 Impact factor: 2.681