February 28, 2019
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Pregnancy loss increases risk for CVD

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Several risk factors for CVD such as hypertension, BMI and diabetes were associated with pregnancy loss, according to a study published in The American Journal of Cardiology.

Philip S. Hall, MD, of the division of cardiology at UNC Rex Healthcare in Raleigh, North Carolina, and colleagues analyzed data from 79,121 women from the Women’s Health Initiative who were parous and did not have pre-existing CVD.

The primary exposure was pregnancy loss, which was defined as a self-reported history of a stillbirth or spontaneous miscarriage. Questionnaires on pregnancy history were completed at baseline and included questions on the number of stillbirths from pregnancies that lasted at least 6 months, live births and spontaneous miscarriages.

CVD risk factors were also assessed at baseline and included systolic BP, BMI, diabetes, hypertension, physical activity, hyperlipidemia, annual household income, alcohol use, neighborhood socioeconomic status index, education level, diet quality and psychosocial history of depression.

A cumulative outcome of interest was incident CVD, which was defined as stroke, acute MI, peripheral artery disease, venous thromboembolism, CVD death or coronary revascularization. Patients were followed up for a mean of 16.6 years.

A history of pregnancy loss was reported by 35% of women in the analysis. Women who reported pregnancy loss were more likely to have hypertension (P < .0001), higher BMI (P < .0001), depression (P < .0001) and diabetes (P = .003). In addition, these women also had lower income (P < .0001), lower physical activity (P = .01) and lower income (P < .0001).

Pregnancy loss was significantly associated with incident CVD after adjusting for CVD risk factors (HR = 1.11; 95% CI, 1.06-1.16).

“[Pregnancy loss] should be recognized as an independent, modest risk marker for CVD, and further investigation into potential underlying mechanisms is warranted,” Hall and colleagues wrote. – by Darlene Dobkowski

Disclosure s : The authors report no relevant financial disclosures.

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