Abstract
Objective
To investigate whether obesity in pregnancy is an independent risk factor for subsequent long-term cardiovascular morbidity during a follow-up period of more than a decade.
Study Design
Data were analyzed from consecutive pregnant women who delivered between 1988 and 1999, and were followed-up retrospectively until 2010. Long-term cardiovascular morbidity was compared among women with and without obesity in pregnancy (defined as maternal pre-pregnancy body mass index (BMI) of 30 kg/m2 or more). Cardiovascular morbidity was divided into four categories including simple and complex cardiovascular events and invasive and noninvasive cardiac procedures. Kaplan-Meier survival curves were used to compare cumulative incidence of cardiovascular hospitalizations. Cox proportional hazards models were used to estimate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for long term cardiovascular hospitalizations.
Results
During the study period 46,688 women met the inclusion criteria; 1221 (2.6%) suffered from obesity during pregnancy. During a follow up period of more than ten years, patients with obesity had higher risk for cardiovascular hospitalizations (Kaplan-Meier survival analysis, P<0.001; Figure). Specifically, obese patients had higher rates of simple cardiovascular events and non-invasive procedures (Table). These complications tended to occur at a younger age (mean 4871±950 days vs. 5060±1140 days from their pregnancy; p=0.001). In a Cox proportional hazards model, adjusted for diabetes mellitus, preeclampsia and maternal age, obesity was independently associated with long-term cardiovascular hospitalizations (adjusted HR 1.33, 95% CI 1.17-1.5).
Conclusion
Obesity during pregnancy is an independent risk factor for long-term cardiovascular morbidity, and these complications tend to occur at a younger age. Obese parturients might benefit from cardiovascular risk screening that could lead to early detection and secondary prevention of cardiovascular morbidity.
To investigate whether obesity in pregnancy is an independent risk factor for subsequent long-term cardiovascular morbidity during a follow-up period of more than a decade.
Study Design
Data were analyzed from consecutive pregnant women who delivered between 1988 and 1999, and were followed-up retrospectively until 2010. Long-term cardiovascular morbidity was compared among women with and without obesity in pregnancy (defined as maternal pre-pregnancy body mass index (BMI) of 30 kg/m2 or more). Cardiovascular morbidity was divided into four categories including simple and complex cardiovascular events and invasive and noninvasive cardiac procedures. Kaplan-Meier survival curves were used to compare cumulative incidence of cardiovascular hospitalizations. Cox proportional hazards models were used to estimate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for long term cardiovascular hospitalizations.
Results
During the study period 46,688 women met the inclusion criteria; 1221 (2.6%) suffered from obesity during pregnancy. During a follow up period of more than ten years, patients with obesity had higher risk for cardiovascular hospitalizations (Kaplan-Meier survival analysis, P<0.001; Figure). Specifically, obese patients had higher rates of simple cardiovascular events and non-invasive procedures (Table). These complications tended to occur at a younger age (mean 4871±950 days vs. 5060±1140 days from their pregnancy; p=0.001). In a Cox proportional hazards model, adjusted for diabetes mellitus, preeclampsia and maternal age, obesity was independently associated with long-term cardiovascular hospitalizations (adjusted HR 1.33, 95% CI 1.17-1.5).
Conclusion
Obesity during pregnancy is an independent risk factor for long-term cardiovascular morbidity, and these complications tend to occur at a younger age. Obese parturients might benefit from cardiovascular risk screening that could lead to early detection and secondary prevention of cardiovascular morbidity.
| Original language | English |
|---|---|
| Pages (from-to) | S45-S45 |
| Journal | American Journal of Obstetrics and Gynecology |
| Volume | 210 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2014 |
