Abstract
Objective
To investigate whether intrauterine fetal death (IUFD) poses a risk for subsequent maternal long term cardiovascular morbidity.
Study Design
A population-based study compared the incidence of long-term cardiovascular morbidity in a cohort of women with and without a previous IUFD. Deliveries occurred during a 25 years period. Patients with multiple pregnancies and with known cardiovascular disease or congenital cardiovascular malformations before the index pregnancy were excluded. Kaplan-Meier survival curve was used to estimate cumulative incidence of cardiovascular hospitalizations. Cox proportional hazards model was used to estimate the adjusted hazards ratio (HR) for cardiovascular hospitalizations.
Results
Of 99280 women that met the inclusion criteria, 1879 (1.9%) occurred in patients who had at least one previous IUFD. Patients following IUFD had a significantly higher cumulative incidence of cardiovascular hospitalizations, using a Kaplan-Meier survival curve (Figure). During the follow-up period (mean 11.2 years), patients with IUFD had higher rates of total cardiovascular hospitalizations (4.9% vs. 3.2 %; OR=1.5, 95% CI 1.2-1.9; P<0.001) and had higher rates of simple (2.2% vs. 1.3 %; OR=1.7, 95% CI 1.2-2.2; P=0.001) as well as complex cardiovascular events (3.0% vs. 1.7 %; OR=1.8, 95% CI 1.4-2.3; P<0.001). A significant linear association (using the chi-square test for trends) was found between the number of IUFD and future risk for cardiovascular morbidity (Table). In a Cox proportional hazards model, adjusted for confounders such as parity, diabetes mellitus, and obesity, IUFD was independently associated with cardiovascular hospitalizations (adjusted HR, 1.5; 95% CI, 1.2-1.9).
Conclusion
IUFD is an independent risk factor for long-term maternal cardiovascular morbidity. The risk is higher for patients with recurrent episodes of IUFD.
To investigate whether intrauterine fetal death (IUFD) poses a risk for subsequent maternal long term cardiovascular morbidity.
Study Design
A population-based study compared the incidence of long-term cardiovascular morbidity in a cohort of women with and without a previous IUFD. Deliveries occurred during a 25 years period. Patients with multiple pregnancies and with known cardiovascular disease or congenital cardiovascular malformations before the index pregnancy were excluded. Kaplan-Meier survival curve was used to estimate cumulative incidence of cardiovascular hospitalizations. Cox proportional hazards model was used to estimate the adjusted hazards ratio (HR) for cardiovascular hospitalizations.
Results
Of 99280 women that met the inclusion criteria, 1879 (1.9%) occurred in patients who had at least one previous IUFD. Patients following IUFD had a significantly higher cumulative incidence of cardiovascular hospitalizations, using a Kaplan-Meier survival curve (Figure). During the follow-up period (mean 11.2 years), patients with IUFD had higher rates of total cardiovascular hospitalizations (4.9% vs. 3.2 %; OR=1.5, 95% CI 1.2-1.9; P<0.001) and had higher rates of simple (2.2% vs. 1.3 %; OR=1.7, 95% CI 1.2-2.2; P=0.001) as well as complex cardiovascular events (3.0% vs. 1.7 %; OR=1.8, 95% CI 1.4-2.3; P<0.001). A significant linear association (using the chi-square test for trends) was found between the number of IUFD and future risk for cardiovascular morbidity (Table). In a Cox proportional hazards model, adjusted for confounders such as parity, diabetes mellitus, and obesity, IUFD was independently associated with cardiovascular hospitalizations (adjusted HR, 1.5; 95% CI, 1.2-1.9).
Conclusion
IUFD is an independent risk factor for long-term maternal cardiovascular morbidity. The risk is higher for patients with recurrent episodes of IUFD.
| Original language | English |
|---|---|
| Pages (from-to) | S311-S312 |
| Journal | American Journal of Obstetrics and Gynecology |
| Volume | 210 |
| Issue number | 1 |
| DOIs | |
| State | Published - 31 Jan 2014 |
