Cardiovascular risk factors tied to poor pregnancy outcomes


Risk factors for heart disease put expectant mothers at higher risk for adverse pregnancy outcomes (APO) as well as increased chances of high blood pressure years after delivery, according to a study published online Feb. 23 in the Journal of the American Heart Association.

Janet M. Catov, Ph.D., from the Magee-Womens Research Institute in Pittsburgh, and colleagues evaluated the association between first-trimester atherogenic markers and the risk for APO (hypertensive disorders of pregnancy, preterm birth, small for gestational age), gestational diabetes mellitus (GDM), and hypertension (130/80 mm Hg or antihypertensive use) two to seven years after delivery.

The researchers found that women with an APO/GDM (1,102 women) had more atherogenic characteristics (obesity; higher blood pressure, diastolic blood pressure, glucose, insulin, triglycerides, and high-sensitivity C-reactive protein; lower high-density lipoprotein cholesterol) versus women without an APO/GDM. Women with an APO/GDM were also more likely to develop hypertension after delivery (32.8 versus 18.1 percent). In an adjusted analysis, the risk for later hypertension was associated with higher glucose (relative risk [RR], 1.03 per 0.6 mmol/L; 95 percent confidence interval [CI], 1.00 to 1.06), high-sensitivity C-reactive protein (RR, 1.06 per twofold higher; 95 percent CI, 1.02 to 1.11), and triglycerides (RR, 1.27 per twofold higher; 95 percent CI, 1.14 to 1.41). Higher physical activity protected against later hypertension (RR, 0.93 [95 percent CI, 0.87 to 0.99] for three hours/week).

“During pregnancy women are in frequent contact with care providers and participate in multiple medical screenings,” Catov said in a statement. “A strong provider-patient partnership can be a first step in identifying potential risks for pregnancy complications, while creating strategies to support the cardiovascular health of a mother and her child for years to come.”

Two authors disclosed financial ties to the pharmaceutical industry.