Risk prediction of maternal cardiovascular disease one year after hypertensive pregnancy complications or gestational diabetes mellitus
| Autor: | Ralf Dechend, Meryam Sugulle, Anne Cathrine Staff, Kjartan Moe |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Gestational hypertension medicine.medical_specialty Time Factors Hypertensive pregnancy Epidemiology Disease 030204 cardiovascular system & hematology Risk Assessment Article Preeclampsia Young Adult 03 medical and health sciences 0302 clinical medicine Pregnancy Risk Factors medicine Humans 030212 general & internal medicine Norway Obstetrics business.industry Incidence Postpartum Period Hypertension Pregnancy-Induced Middle Aged medicine.disease Gestational diabetes Diabetes Gestational Cardiovascular Diseases Female Cardiology and Cardiovascular Medicine business Postpartum period Follow-Up Studies |
| Zdroj: | Eur J Prev Cardiol |
| ISSN: | 2047-4881 2047-4873 |
| DOI: | 10.1177/2047487319879791 |
| Popis: | Background Previous preeclampsia, gestational hypertension and gestational diabetes mellitus show a firm epidemiological association to maternal cardiovascular disease risk. Cardiovascular disease risk assessment is recommended in women after these pregnancy complications, but not offered in most countries. We therefore wanted to evaluate the applicability of currently recommended cardiovascular disease risk scores for women one-year postpartum of such pregnancy complications. Design and methods We tested applicability of three scoring systems, the Atherosclerotic Cardiovascular Disease (ASCVD) score, the Joint British Societies for the Prevention of Cardiovascular Disease (JBS3) score and Framingham 30 year Risk Score-Cardiovascular Disease (FRS-CVD) in 235 women one-year postpartum (controls: 94, gestational hypertension: 35, preeclampsia: 81, gestational diabetes mellitus: 25). Statistical analysis was performed with Mann–Whitney U test for continuous and Fisher’s mid-corrected p and Pearson’s r for dichotomous variables. A value of p Results Most women (87.7%) were below 40 years of age, rendering 10-year risk estimations recommended by American and European societies inapplicable. FRS-CVD could be assessed in all women. Significantly fewer could be assessed by the ASCVD (81.5%) and JBS3 (91.6%). All scoring systems showed small, but significant increases in risk scores for one or more of the pregnancy complication groups, but none at the risk magnitude for cardiovascular disease shown in epidemiological studies. Conclusion We demonstrate that ASCVD, JBS3 and FRS-CVD are inadequate in assessing cardiovascular disease risk one-year postpartum. We suggest that pregnancy complications need to be considered separately when evaluating maternal cardiovascular disease risk and need for postpartum follow-up. |
| Databáze: | OpenAIRE |
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