Early or late pregnancy loss and development of clinical cardiovascular disease risk factors: a prospective cohort study.

Autor:	Horn, J, Tanz, LJ, Stuart, JJ, Markovitz, AR, Skurnik, G, Rimm, EB, Missmer, SA, Rich‐Edwards, JW, Tanz, L J, Stuart, J J, Markovitz, A R, Rimm, E B, Missmer, S A, Rich-Edwards, J W
Předmět:	MISCARRIAGE CARDIOVASCULAR diseases risk factors CARDIOVASCULAR diseases in pregnancy HYPERCHOLESTEREMIA STILLBIRTH HYPERTENSION epidemiology ABORTION statistics CONFIDENCE intervals GESTATIONAL age HYPERTENSION LONGITUDINAL method EVALUATION of medical care TYPE 2 diabetes PERINATAL death PREGNANCY RESEARCH funding PROPORTIONAL hazards models
Zdroj:	BJOG: An International Journal of Obstetrics & Gynaecology; Jan2019, Vol. 126 Issue 1, p33-42, 10p, 3 Charts
Abstrakt:	Objective: To assess the association between the outcome of a woman's first pregnancy and risk of clinical cardiovascular disease risk factors.Design: Prospective cohort study.Setting and Population: Nurses' Health Study II.Methods: Multivariable-adjusted Cox proportional hazards models were used to compute hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between first pregnancy outcome and hypertension, type 2 diabetes, and hypercholesterolemia.Main Outcome Measures: Hypertension, type 2 diabetes, and hypercholesterolemia.Results: Compared to women who reported a singleton live first birth, women with early spontaneous abortion (<12 weeks) had a greater rate of type 2 diabetes (HR: 1.20; 95% CI: 1.07-1.34) and hypercholesterolemia (HR: 1.06; 95% CI: 1.02-1.10), and a marginally increased rate of hypertension (HR: 1.05, 95% CI: 1.00-1.11). Late spontaneous abortion (12-19 weeks) was associated with an increased rate of type 2 diabetes (HR: 1.38; 95% CI: 1.14-1.65), hypercholesterolemia (HR: 1.11; 95% CI: 1.03-1.19), and hypertension (HR: 1.15; 95% CI: 1.05-1.25). The rates of type 2 diabetes (HR: 1.45; 95% CI: 1.13-1.87) and hypertension (HR: 1.15; 95% CI: 1.01-1.30) were higher in women who delivered stillbirth. In contrast, women whose first pregnancy ended in an induced abortion had lower rates of hypertension (HR: 0.87; 95% CI: 0.84-0.91) and type 2 diabetes (HR: 0.89; 95% CI: 0.79-0.99) than women with a singleton live birth.Conclusions: Several types of pregnancy loss were associated with an increased rate of hypertension, type 2 diabetes, and hypercholesterolemia, which may provide novel insight into the pathways through which pregnancy outcomes and CVD are linked.Tweetable Abstract: Pregnancy loss is associated with later maternal risk of hypertension, type 2 diabetes, and hypercholesterolemia. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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