Is stillbirth associated with long-term atherosclerotic morbidity?

Gali Pariente, Ilana Shoham-Vardi, Roy Kessous, Ruslan Sergienko, Eyal Sheiner

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Objective The purpose of this study was to investigate whether women who experienced at least 1 stillbirth are at increased risk for subsequent maternal long-term atherosclerotic morbidity. Study Design We conducted a population-based study that compared the incidence of long-term atherosclerotic morbidity in a cohort of women with and without previous stillbirth. Deliveries occurred during a 25-year period. Patients with known cardiovascular or renal disease before the index pregnancy were excluded from the study. Kaplan-Meier survival curves were used to estimate the cumulative incidence of cardiovascular- and renal-related hospitalizations. Cox proportional hazards models were used to estimate the adjusted hazards ratio for cardiovascular- and renal-related hospitalizations.

Results Of 99,280 deliveries that met the inclusion criteria, 1879 deliveries (1.9%) occurred in patients who had had at least 1 stillbirth. After stillbirth, patients had a significantly higher cumulative incidence of cardiovascular and renal morbidity (Kaplan-Meier survival curve). During the follow-up period, patients with at least 1 stillbirth had higher rates of total cardiovascular and renal hospitalizations and had higher rates of simple and complex cardiovascular events. A significant stepwise increase was found between the number of stillbirths and future risk for cardiovascular morbidity. In a Cox proportional hazards model that was adjusted for confounders, previous stillbirth was associated independently with atherosclerotic morbidity.

Conclusion Stillbirth is an independent risk factor for long-term maternal atherosclerotic morbidity. The risk is higher for patients with recurrent episodes of stillbirth.

Original languageEnglish
Pages (from-to)416.e1-416.e12
JournalAmerican Journal of Obstetrics and Gynecology
Volume211
Issue number4
DOIs
StatePublished - 1 Oct 2014

Keywords

  • atherosclerosis
  • long-term
  • maternal
  • morbidity
  • stillbirth

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