Pregnancy complications may signal later risk of heart disease death

http://www.eurekalert.org/pub_releases/2015-09/aha-pcm091715.php

Public Release: 21-Sep-2015
Pregnancy complications may signal later risk of heart disease death
American Heart Association Rapid Access Journal Report
American Heart Association

Women who experience complications during pregnancy may be at greater risk of dying from heart disease later in life than women with uncomplicated pregnancies, according to new research in the American Heart Association's journal Circulation.

Cardiovascular diseases (CVD) is the No. 1 killer of American women. According to the American Heart Association, 399,503 women died of CVD in 2013. CVD is also the leading cause of death among American men.

Researchers analyzed data from the Public Health Institute's Child Health and Development Studies (CHDS), which enrolled 15,528 pregnant women in the Oakland, Calif., metropolitan area from 1959 to 1967. As of 2011, 368 women (average age 66) had died of CVD. Researchers confirmed several pregnancy complications associated with CVD reported in other studies (pre-eclampsia, pre-term delivery and small-for-gestational-age delivery) but here also found that preeclampsia in early pregnancy strongly predicts premature CVD death before age 60. They also found CVD death risk increased significantly for combinations of pregnancy events:

7.1 times when a mother had pre-existing high blood pressure (diagnosed up to 20 weeks of pregnancy) and a pre-term delivery.

5.6 times for pre-existing high blood pressure and pre-eclampsia (characterized by high blood pressure and high level of protein in the urine).

4.8 times for pre-existing high blood pressure and small-for-gestational-age delivery.

5 times for gestational high blood pressure and preterm delivery.

Researchers also identified two new pregnancy complications that predispose women to CVD death:

4.2 times when glycosuria, or high levels of sugar, were found in the urine.

1.7 times for hemoglobin decline, a measure of the red blood cells' ability to carry oxygen throughout the body.

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Researchers also reported an unexpected result: high blood pressure that developed after 20 weeks of pregnancy was associated with CVD only in African-American women. African-Americans, who made up 22 percent of the study population, were 1.7 times more likely to die of CVD, while white, Asian and Hispanic women had no increased risk due to gestational hypertension.

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