Document Detail


Associations of pregnancy complications with calculated cardiovascular disease risk and cardiovascular risk factors in middle age: the Avon Longitudinal Study of Parents and Children.
MedLine Citation:
PMID:  22344039     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The nature and contribution of different pregnancy-related complications to future cardiovascular disease (CVD) and its risk factors and the mechanisms underlying these associations remain unclear.
METHODS AND RESULTS: We studied associations of pregnancy diabetes mellitus, hypertensive disorders of pregnancy, preterm delivery, and size for gestational age with calculated 10-year CVD risk (based on the Framingham score) and a wide range of cardiovascular risk factors measured 18 years after pregnancy (mean age at outcome assessment, 48 years) in a prospective cohort of 3416 women. Gestational diabetes mellitus was positively associated with fasting glucose and insulin, even after adjustment for potential confounders, whereas hypertensive disorders of pregnancy were associated with body mass index, waist circumference, blood pressure, lipids, and insulin. Large for gestational age was associated with greater waist circumference and glucose concentrations, whereas small for gestational age and preterm delivery were associated with higher blood pressure. The association with the calculated 10-year CVD risk based on the Framingham prediction score was odds ratio 1.31 (95 confidence interval, 1.11-1.53) for preeclampsia and 1.26 (95 confidence interval, 0.95-1.68) for gestational diabetes mellitus compared with women without preeclampsia and without gestational diabetes mellitus, respectively.
CONCLUSIONS: Hypertensive disorders of pregnancy and pregnancy diabetes mellitus are independently associated with an increased calculated 10-year CVD risk. Preeclampsia may be the better predictor of future CVD because it was associated with a wider range of cardiovascular risk factors. Our results suggest that pregnancy may be an important opportunity for early identification of women at increased risk of CVD later in life.
Authors:
Abigail Fraser; Scott M Nelson; Corrie Macdonald-Wallis; Lynne Cherry; Elaine Butler; Naveed Sattar; Debbie A Lawlor
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-02-17
Journal Detail:
Title:  Circulation     Volume:  125     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-03-20     Completed Date:  2012-05-04     Revised Date:  2014-02-24    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1367-80     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Child
Cohort Studies
Diabetes, Gestational / diagnosis*,  epidemiology*
Female
Follow-Up Studies
Humans
Longitudinal Studies
Middle Aged
Pre-Eclampsia / diagnosis*,  epidemiology*
Pregnancy
Pregnancy Complications, Cardiovascular / diagnosis*,  epidemiology*
Premature Birth / diagnosis,  epidemiology
Prospective Studies
Risk Factors
Grant Support
ID/Acronym/Agency:
0701594//Medical Research Council; 076467//Wellcome Trust; 087997//Wellcome Trust; 092731//Wellcome Trust; G0600705//Medical Research Council; G0701594//Medical Research Council; G0701594(84937)//Medical Research Council; G1001357//Medical Research Council; PG/11/33/28794//British Heart Foundation; R01 DK077659/DK/NIDDK NIH HHS; SP/07/008/24066//British Heart Foundation; WT076467//Wellcome Trust; WT087997//Wellcome Trust
Comments/Corrections
Comment In:
Circulation. 2012 Mar 20;125(11):1336-8   [PMID:  22354939 ]

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