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Adverse Pregnancy Outcomes Tied to Later Atherosclerotic CVD

Findings remain when adjusting for standard risk factors, other adverse pregnancy outcomes

TUESDAY, Sept. 22, 2020 (HealthDay News) -- Adverse pregnancy outcomes (APOs), particularly hypertensive disorders of pregnancy and low birth weight, may be risk factors for atherosclerotic cardiovascular disease (ASCVD) in older women, according to a study published online Sept. 16 in JAMA Cardiology.

Marc Meller Søndergaard, from Aalborg University in Denmark, and colleagues assessed whether APOs (gestational diabetes, hypertensive disorders of pregnancy, low birth weight, high birth weight, and preterm delivery) are associated with increased ASCVD risk using data from 48,113 postmenopausal participants (median age, 60 years) in the Women's Health Initiative.

The researchers found that 28.8 percent of participants reported one or more APO. Compared with women without APOs, ASCVD was more frequent in women who reported an APO (7.6 versus 5.8 percent). When analyzed separately, each APO was significantly associated with ASCVD. Gestational diabetes, hypertensive disorders of pregnancy, low birth weight, and preterm delivery remained significantly associated with ASCVD after adjusting for traditional ASCVD risk factors. Hypertensive disorders of pregnancy (odds ratio, 1.27; 95 percent confidence interval, 1.15 to 1.40) and low birth weight (odds ratio, 1.12; 95 percent confidence interval, 1.00 to 1.26) remained independently associated with ASCVD when all APOs were analyzed together. Additional adjustment for parity, body mass index, and socioeconomic factors did not change the findings.

"Our study supports guideline recommendations that clinicians should consider a history of pregnancy-associated disorders when assessing ASCVD risk in older women," the authors write.

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