Pregnancy was not significantly associated with an increased risk of acute aortic dissection in women aged 15 to 45 years (RR 3.27; 95% CI 0.82-12.95; P=0.14).
Cohort (n=341,381)
No
Does pregnancy increase the risk of acute type A aortic dissection in women younger than 45 years of age?
In a population-based study, pregnancy was not found to be a statistically significant independent risk factor for acute type A aortic dissection in women under 45 years of age, challenging previous reports.
Relative Risk: 3.27 (95% CI 0.82–12.95)
p-value: p=0.14
OBJECTIVE: Pregnancy has been reported to be an independent risk factor for 50% of acute aortic dissections recorded in women younger than 45 years of age. The present epidemiologic study aimed to identify whether this putative association of pregnancy and acute type A dissection could be an artifact of selective reporting. METHODS: This population-based study was conducted in the City of Vienna, Austria, Europe, in an average female population of 34,1381 women in the age range of 15-45 years who were followed up between 1994 and 2004 (total of 3755.195 person-years of observation). During this study, the incidence, management, and outcome of acute type A dissection were determined. RESULTS: Fifteen patients (mean age: 38.8 years, SD: 4.8) with acute aortic dissection were identified, and an overall incidence of 0.4 case per 100000 person-years was estimated. The prehospital mortality rate was recorded to be 53%. Six patients, including two women in late pregnancy (incidence: 0.05 cases per 100000 person-years), were treated successfully by surgical repair during deep hypothermic circulatory arrest (in-hospital mortality rate: 6.6%). Pregnancy and aortic dissection were identified as events that were not related (RR: 3.27; 95% confidence interval (CI): 0.82-12.95; P=0.14). Observation during long-term follow-up was uneventful. CONCLUSIONS: Acute aortic dissection represents a rare pathology in women younger than 45 years of age; however, it is associated with a high rate of sudden death. Pregnancy may not be a risk factor for this life-threatening vascular emergency. Immediate referral to surgery, even during pregnancy, will result in a prognosis of favorable outcome.
Thalmann et al. (2011) conducted a cohort in Acute type A aortic dissection (n=341,381). Pregnancy vs. Non-pregnant state was evaluated on Acute aortic dissection (RR 3.27, 95% CI 0.82-12.95, p=0.14). Pregnancy was not significantly associated with an increased risk of acute aortic dissection in women aged 15 to 45 years (RR 3.27; 95% CI 0.82-12.95; P=0.14).