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Preterm delivery may increase CVD risk in women independent of other risk factors
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Preterm delivery was found to be predictive of CVD independent of prepregnancy lifestyle and other CVD risk factors, according to research recently published in the inaugural Go Red for Women issue in Circulation.
“Preterm delivery is independently predictive of CVD, even after adjustment for multiple cardiometabolic risk factors, and the association is mediated only in part by the postpartum development of traditional CVD risk factors,” Lauren J. Tanz, MSPH, from the department of epidemiology, Harvard T.H. Chan School of Public Health, and colleagues wrote. “Ultimately, preterm delivery may be a useful prognostic tool to identify high-risk women early in life who would benefit from early screening, prevention and treatment.”
Tanz and colleagues examined data on 70,182 women from the Nurses’ Health Study II. The researchers used multivariable Cox proportional hazards models to examine the association between history of preterm delivery and CVD (MI and stroke) risk while accounting for age, race, parental education, as well as prepregnancy lifestyle and CVD risk factors. Preterm delivery was defined as infant delivery at less than 37 weeks of pregnancy.
In women experiencing a first pregnancy, CVD risk was associated with a greater risk after preterm delivery (HR = 1.42; 95% CI, 1.16-1.72) vs. after full-term delivery, according to the researchers.
With moderate preterm delivery (≥ 32 weeks to < 37 weeks), the HR was 1.22 (95% CI, 0.96-1.54), and with very preterm delivery (< 32 weeks), the HR was 2.01 (95% CI, 1.47-2.75), Tanz and colleagues found.
Compared with women who had at least two pregnancies, all of which were delivered to term, women who had at least two preterm births had a 65% increased risk for CVD (HR = 1.65; 95% CI, 1.2-2.28).
“Less than 25% of this increased risk is explained by hypertension, hypercholesterolemia, type 2 diabetes and changes in [BMI] developing after the first birth,” Tanz and colleagues wrote in a clinical perspective. – by Suzanne Reist
Disclosure: The researchers report no relevant financial disclosures.
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