Key result
Gestational hypertension is linked to ~358% greater risk of later-life hypertension and MI.
Why the study?
Adverse pregnancy outcomes have been linked to increased cardiovascular risk and mortality, but the underlying pathomechanisms for developing cardiovascular disease in these women remain poorly understood.
Are adverse pregnancy outcomes associated with adverse cardiovascular risk profiles and cardiac remodeling in later life?
Observational (n=1,970)
Are adverse pregnancy outcomes associated with adverse cardiovascular risk profiles and cardiac remodeling in later life?
Odds Ratio: 4.58 (95% CI 2.79–7.86)
p-value: p=< 0.001
Adverse pregnancy outcomes, particularly gestational hypertension, are associated with worse cardiovascular risk profiles and cardiac remodeling in later life, highlighting the need for early risk stratification.
Supports targeted CV risk assessment post-APO; leaves open causal pathways and need for prospective outcome trials.
BACKGROUND AND AIMS: Adverse pregnancy outcomes (APO) have been related to increased cardiovascular (CV) risk and mortality in later life. Underlying pathomechanisms for the development of CV disease in these women are not yet fully understood. In this study, we aimed to investigate the relationship between APO and individual CV risk profiles in later life. METHODS: -test were performed. Multivariable-adjusted regression models were calculated to determine associations. RESULTS: N = 1970 women who reported pregnancies were included. Median age was 63 years, 8.7 % reported gestational hypertension (gHTN), 18 % excessive weight gain and 2.4 % gestational diabetes. Ten percent had delivered newborns with birth weight <2.5 kg, 14 % newborns with birth weight >4 kg. In multivariable-adjusted models, significant associations between APO, CV risk profiles and cardiac remodeling were identified. gHTN correlated with higher body mass index (BMI) (Beta 1.68, CI 95 % 0.86-2.50; p < 0.001), hypertension (OR 4.58, CI 95 % 2.79-7.86; p < 0.001), left ventricular remodeling (e.g. left ventricular mass index (Beta 4.46, CI 95 % 1.05-7.87; p = 0.010)) and myocardial infarction (OR 3.27, CI 95 % 0.94-10.07; p = 0.046). CONCLUSIONS: In this population-based sample, APO were associated with CV risk profiles and cardiac remodeling in later life, suggesting early manifestations of future CV risk during pregnancy. Prospective data is needed for individual risk stratification in women with APO.
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Unger et al. (2024) conducted an observational in Adverse pregnancy outcomes and cardiovascular risk (n=1,970). Gestational hypertension vs. No gestational hypertension was evaluated on Hypertension in later life (OR 4.58, 95% CI 2.79-7.86, p=< 0.001). Gestational hypertension was significantly associated with a higher risk of later-life hypertension (OR 4.58; 95% CI 2.79-7.86; p<0.001) and myocardial infarction (OR 3.27; 95% CI 0.94-10.07; p=0.046).
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