Abstract 18819: Adverse Pregnancy Outcomes and Their Prediction of Future Heart Disease
Objective: Pregnancy provides an opportunity for a natural stress test, with the physiological demands of pregnancy acting as a maternal stress test that can predict a woman’s health later in life. The 2011 Update of the American Heart Association’s Evidence-Based Guidelines for the Prevention of Cardiovascular Disease in Women identifies many complications of pregnancy as relevant in the determination of cardiovascular disease (CVD) risk. This is important because CVD is the leading cause of death in women worldwide. The purpose of this research was to determine if, in our diverse inner city population, pregnancies complicated by hypertensive disorders, gestational diabetes, intrauterine growth restriction, or abruption were associated with future development of CVD.
Methods: We identified women who delivered at a large, urban hospital in Bronx, NY from 1997-2001 who were treated for gestational diabetes, hypertensive disorders of pregnancy, intrauterine growth restriction, and placental abruption (n=183). A hospital database was used to identify our cohort and electronic medical records were reviewed to determine if these patients developed CVD over 10 years since the index pregnancy. The end points were subsequent Hypertension, Myocardial Infarction, Cerebrovascular disease, Type 2 Diabetes Mellitus, and Thromboembolic events. The cohort was compared to controls delivered at the same institution.
Results: The relative risk (RR) of subsequent type 2 diabetes mellitus was 1.93 [CI 1.00-3.75], if the exposed population was older than 35 at the time of the index pregnancy. The RR of subsequent hypertension was 2.21 [CI 1.3-3.77] in African Americans at any age of index pregnancy, regardless of exposure. When comparing all exposed population to our controls; there is an increased risk in our population of CVD with a RR of 1.58 (CI 1.12-.2.23), and a p value of 0.01.
Conclusions: In our large, diverse, urban population, age or the presence of preeclampsia were associated with an increased risk for adverse CVD. These women may be appropriate for early CVD risk screening and intervention at younger ages than previously identified. Women with adverse pregnancy outcomes should be targeted for risk factor modification and prevention programs.
Author Disclosures: P. Green: None. D. Fridman: None. H. Smith: None. M. Rosser: None.
- © 2015 by American Heart Association, Inc.