116: Giving birth to a small for gestational age infant is a risk factor for long-term maternal cardiovascular morbidity

Objective
To investigate whether women with a prior occurrence of small-for-gestational-age (SGA) are at an increased risk for subsequent long term maternal cardiovascular morbidity.
Study Design
A population-based study comparing consecutive pregnancies of women with and without a previous delivery of a SGA neonate was conducted. Deliveries occurred during the years 1988-1999, with a follow-up period until 2010. Incidence of long-term cardiovascular morbidity was compared between women with SGA neonate and women who gave birth at the same period to an appropriate for gestational age neonate. Logistic regression was conducted to obtain adjusted odds ratios (AOR) and 95 % confidence intervals (CI) for the association between SGA and subsequent cardiovascular morbidity.

Results
During the study period 47612 deliveries met the inclusion criteria; 9.3% (n=4411) occurred in patients with a prior occurrence of SGA. Women with a prior occurrence of SGA had higher rates of long term complex cardiovascular events such as congestive heart failure, cardiac arrest etc. (OR=2.3; 95% CI 1.3-4.4, P=0.006) and long term cardiovascular mortality (OR= 3.4; 95% CI 1.5-7.6, P=0.006; table). Using a multivariable logistic regression model, controlling for confounders such as maternal age and ethnicity, having delivered a SGA neonate was noted as an independent risk factor for long-term maternal cardiovascular hospitalizations (AOR= 1.4; 95% CI-1.1-1.6, P < 0.001).
Long term cardiovascular morbidity and mortality in patients with and without a prior occurrence of SGA
Conclusion
Delivery of a previous SGA infant is an important predictor of long-term maternal cardiovascular morbidity during a follow-up period of more than a decade.