Abstract P314: Higher C-Reactive Protein Levels Among Women with a History of Hypertensive Disorders of Pregnancy
Introduction: Women with a history of pregnancy complications, including hypertensive disorders of pregnancy (HDP: preeclampsia and gestational hypertension) and preterm delivery (<37 weeks), have an increased risk of cardiovascular disease (CVD). There is limited knowledge of the pathway linking pregnancy outcomes and CVD, but chronic inflammation may play a role.
Methods: We selected parous women from the Nurses’ Health Study II who had the inflammatory biomarkers C-reactive protein (CRP; n=2,987) or interleukin (IL)-6 (n=2,916) assessed in stored blood samples provided after pregnancy, between 1996 and 1999. Women were selected from previous nested case-control biomarker studies. Robust linear regression models were used to separately evaluate the mean differences in CRP and IL-6 and 95% confidence intervals (CIs) associated with a history of HDP compared to no such history and with a history of preterm delivery compared to no such history. Models were adjusted for age at blood draw, pre-pregnancy body mass index and smoking, and variables related to lab selection.
Results: Ten percent (285 of 2,987) of women had a history of HDP, while 12% (358 of 2,987) had at least one preterm delivery prior to blood draw. Median time from first pregnancy to blood draw was 17 years (range: 1-37 years). Mean CRP levels were 2.00 mg/L and 1.57 mg/L, while mean IL-6 levels were 1.56 pg/mL and 1.42 pg/mL in women with and without a history of HDP, respectively. In women with and without preterm delivery, mean CRP levels were 1.54 mg/L and 1.62 mg/L and mean IL-6 levels were 1.39 pg/mL and 1.44 pg/mL, respectively. Plasma levels of CRP were 0.36 mg/L (95% CI: 0.12, 0.60) higher, on average, in women with a history of HDP compared to those with all normotensive pregnancies. Plasma IL-6 levels were not significantly higher among women with a history HDP (0.06 pg/mL, 95% CI: -0.16, 0.27). There were no significant differences in CRP (-0.11 mg/L, 95% CI: -0.30, 0.07) or IL-6 (-0.08 pg/mL, 95% CI: -0.25, 0.10) levels in women with a history of preterm delivery.
Conclusion: CRP was elevated in women with a history of HDP in the decades following pregnancy, suggesting a potential inflammatory response. An altered inflammatory profile was not present in women with a history of preterm delivery. Further investigation is needed to confirm these inflammatory responses in women with a history of pregnancy complications and to evaluate the utility of CRP as a potential risk marker in CVD screening.
Author Disclosures: L.J. Tanz: None. J.J. Stuart: None. E.B. Rimm: None. M.A. Vadnais: None. S.A. Missmer: None. E.N. Hibert: None. J.W. Rich-Edwards: None.
- © 2017 by American Heart Association, Inc.