Cesarean delivery tied to increased CVD complication risks for previously healthy women

Key takeaways:

• Cesarean delivery increased CVD hospital readmission risk vs. vaginal delivery.
• The strongest CVD risk for women who underwent cesarean delivery was for heart failure.

Previously healthy women who underwent cesarean delivery had increased short-term risk for CVD complications after delivery, according to data presented at The Pregnancy Meeting.

“In 2022, one-third of patients were delivered via cesarean. The findings of this study suggest that patients who have a cesarean may face an increased risk of serious cardiac complications,” Cande V. Ananth, PhD, MPH, professor, vice chair for academic affairs and chief of the division of epidemiology and biostatistics in the department of obstetrics, gynecology and reproductive sciences at Rutgers Robert Wood Johnson Medical School in New Brunswick, New Jersey, told Healio. “Cesarean deliveries are associated with a 47% increased risk of short-term cardiovascular complications when compared to vaginal deliveries, and this risk is elevated for at least 1 year after delivery.”

Ananth and colleagues conducted a retrospective cohort study analyzing data from 30,039,844 singleton delivery hospitalizations from 2010 to 2018 obtained from the Nationwide Readmissions Database. Researchers identified women with CVD readmission within the calendar year of their index delivery.

Overall, 32% of women underwent cesarean delivery. CVD hospital readmissions occurred among 255.2 per 100,000 cesarean deliveries compared with 133.9 per 100,000 vaginal deliveries.

When controlling for patient and hospital characteristics and hypertensive and diabetes disorders, researchers observed an increase in hospital readmission for CVD (adjusted HR = 1.42; 95% CI, 1.35-1.5), coronary heart disease (aHR = 1.46; 95% CI, 1.38-1.5) and stroke (aHR = 1.17; 95% CI, 1.05-1.31) in women with cesarean delivery. CVD risk for women who underwent cesarean delivery was strongest for heart failure (HR = 1.5; 95% CI, 1.36-1.65). CVD hospital readmission risk continued for up to 1 year after delivery.

“Further research into the long-standing implications of this association is warranted. For example, does having a cesarean delivery increase your risk of CVD later in life?” Ananth said. “Additionally, this study looked at patients without preexisting CVD. The next steps include investigating the association between cesarean delivery and CVD complications in patients with preexisting CVD.”

For more information:

Cande V. Ananth, PhD, MPH, can be reached at ananthcv@rwjms.rutgers.edu.

Reference:

• Lobitz G, et al. Am J Obstet Gynecol. 2024;doi:10.1016/j.ajog.2023.11.072.