Abstract
Objective
To investigate whether patients with a history of recurrent pregnancy loss (RPL) have an increased risk for future maternal cardiovascular (CV) morbidity.
Study Design
A population-based study compared the incidence of long-term CV morbidity in a cohort of women with and without a diagnosis of RPL. Deliveries occurred since the year 1988, with a mean follow-up duration of 11.2 years. We excluded from the study women with known CV disease and congenital cardiovascular malformations, chronic hypertension and multiple pregnancies. CV morbidity was divided into 4 categories according to severity and type including simple and complex CV events (eg, angina pectoris and congestive heart failure, respectively), and invasive and noninvasive cardiac procedures (eg, insertion of a stent and a treadmill stress test, respectively). Kaplan-Meier survival curve was used to estimate cumulative incidence of CV hospitalizations. Cox proportional hazards models were used to estimate the adjusted hazard ratios (HR) for CV morbidity.
Results
During the study period 99,285 parturient met the inclusion criteria; 6.7% (n=6690) occurred in patients with a history of RPL. During the follow-up period patients with RPL had higher rates of cardiovascular morbidity including cardiac invasive and noninvasive diagnostic procedures, simple as well as complex cardiovascular events, and hospitalizations due to cardiovascular causes (table). Using a Kaplan-Meier survival curve, patients with a previous diagnosis of RPL had a significantly higher cumulative incidence of cardiovascular hospitalizations (Figure). Using a Cox proportional hazards model, adjusted for confounders such as preeclampsia, diabetes mellitus, and obesity, a history of RPL remained independently associated with CV hospitalizations (adjusted HR, 1.7; 95% CI, 1.5-1.8; P=0.001).
Conclusion
Recurrent pregnancy loss is an independent risk factor for long term maternal cardiovascular complications and for hospitalizations due to a cardiovascular cause.
To investigate whether patients with a history of recurrent pregnancy loss (RPL) have an increased risk for future maternal cardiovascular (CV) morbidity.
Study Design
A population-based study compared the incidence of long-term CV morbidity in a cohort of women with and without a diagnosis of RPL. Deliveries occurred since the year 1988, with a mean follow-up duration of 11.2 years. We excluded from the study women with known CV disease and congenital cardiovascular malformations, chronic hypertension and multiple pregnancies. CV morbidity was divided into 4 categories according to severity and type including simple and complex CV events (eg, angina pectoris and congestive heart failure, respectively), and invasive and noninvasive cardiac procedures (eg, insertion of a stent and a treadmill stress test, respectively). Kaplan-Meier survival curve was used to estimate cumulative incidence of CV hospitalizations. Cox proportional hazards models were used to estimate the adjusted hazard ratios (HR) for CV morbidity.
Results
During the study period 99,285 parturient met the inclusion criteria; 6.7% (n=6690) occurred in patients with a history of RPL. During the follow-up period patients with RPL had higher rates of cardiovascular morbidity including cardiac invasive and noninvasive diagnostic procedures, simple as well as complex cardiovascular events, and hospitalizations due to cardiovascular causes (table). Using a Kaplan-Meier survival curve, patients with a previous diagnosis of RPL had a significantly higher cumulative incidence of cardiovascular hospitalizations (Figure). Using a Cox proportional hazards model, adjusted for confounders such as preeclampsia, diabetes mellitus, and obesity, a history of RPL remained independently associated with CV hospitalizations (adjusted HR, 1.7; 95% CI, 1.5-1.8; P=0.001).
Conclusion
Recurrent pregnancy loss is an independent risk factor for long term maternal cardiovascular complications and for hospitalizations due to a cardiovascular cause.
| Original language | English |
|---|---|
| Pages (from-to) | S163 |
| Journal | American Journal of Obstetrics and Gynecology |
| Volume | 210 |
| Issue number | 1 |
| DOIs | |
| State | Published - 31 Jan 2014 |
