Cargando…

The value of pregnancy complication history for 10-year cardiovascular disease risk prediction in middle-aged women

Women with a history of hypertensive disorders of pregnancy (HDP; preeclampsia and gestational hypertension) or delivering low birth weight offspring (LBW; < 2500 g) have twice the risk of cardiovascular disease (CVD). We aimed to study the extent to which history of these pregnancy complications...

Descripción completa

Detalles Bibliográficos
Autores principales: Timpka, Simon, Fraser, Abigail, Schyman, Tommy, Stuart, Jennifer J., Åsvold, Bjørn Olav, Mogren, Ingrid, Franks, Paul W., Rich-Edwards, Janet W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Netherlands 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6153555/
https://www.ncbi.nlm.nih.gov/pubmed/30062549
http://dx.doi.org/10.1007/s10654-018-0429-1
_version_ 1783357525430632448
author Timpka, Simon
Fraser, Abigail
Schyman, Tommy
Stuart, Jennifer J.
Åsvold, Bjørn Olav
Mogren, Ingrid
Franks, Paul W.
Rich-Edwards, Janet W.
author_facet Timpka, Simon
Fraser, Abigail
Schyman, Tommy
Stuart, Jennifer J.
Åsvold, Bjørn Olav
Mogren, Ingrid
Franks, Paul W.
Rich-Edwards, Janet W.
author_sort Timpka, Simon
collection PubMed
description Women with a history of hypertensive disorders of pregnancy (HDP; preeclampsia and gestational hypertension) or delivering low birth weight offspring (LBW; < 2500 g) have twice the risk of cardiovascular disease (CVD). We aimed to study the extent to which history of these pregnancy complications improves CVD risk prediction above and beyond conventional predictors. Parous women attended standardized clinical visits in Sweden. Data were linked to registries of deliveries and CVD. Participants were followed for a first CVD event within 10 years from age 50 (n = 7552) and/or 60 years (n = 5360) and the predictive value of each pregnancy complication above and beyond conventional predictors was investigated. History of LBW offspring was associated with increased risk of CVD when added to conventional predictors in women 50 years of age [Hazard ratio 1.68, 95% Confidence interval (CI) 1.19, 2.37] but not at age 60 (age interaction p = 0.04). However, at age 50 years CVD prediction was not further improved by information on LBW offspring, except that a greater proportion of the women who developed CVD were assigned to a higher risk category (categorical net reclassification improvement for events 0.038, 95% CI 0.003, 0.074). History of HDP was not associated with CVD when adjusted for reference model predictors. In conclusion, a history of pregnancy complications can identify women with increased risk of CVD midlife. However, considered with conventional risk factors, history of HDP or having delivered LBW offspring did not meaningfully improve 10-year CVD risk prediction in women age 50 years or older. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s10654-018-0429-1) contains supplementary material, which is available to authorized users.
format Online
Article
Text
id pubmed-6153555
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Springer Netherlands
record_format MEDLINE/PubMed
spelling pubmed-61535552018-10-09 The value of pregnancy complication history for 10-year cardiovascular disease risk prediction in middle-aged women Timpka, Simon Fraser, Abigail Schyman, Tommy Stuart, Jennifer J. Åsvold, Bjørn Olav Mogren, Ingrid Franks, Paul W. Rich-Edwards, Janet W. Eur J Epidemiol Cardiovascular Disease Women with a history of hypertensive disorders of pregnancy (HDP; preeclampsia and gestational hypertension) or delivering low birth weight offspring (LBW; < 2500 g) have twice the risk of cardiovascular disease (CVD). We aimed to study the extent to which history of these pregnancy complications improves CVD risk prediction above and beyond conventional predictors. Parous women attended standardized clinical visits in Sweden. Data were linked to registries of deliveries and CVD. Participants were followed for a first CVD event within 10 years from age 50 (n = 7552) and/or 60 years (n = 5360) and the predictive value of each pregnancy complication above and beyond conventional predictors was investigated. History of LBW offspring was associated with increased risk of CVD when added to conventional predictors in women 50 years of age [Hazard ratio 1.68, 95% Confidence interval (CI) 1.19, 2.37] but not at age 60 (age interaction p = 0.04). However, at age 50 years CVD prediction was not further improved by information on LBW offspring, except that a greater proportion of the women who developed CVD were assigned to a higher risk category (categorical net reclassification improvement for events 0.038, 95% CI 0.003, 0.074). History of HDP was not associated with CVD when adjusted for reference model predictors. In conclusion, a history of pregnancy complications can identify women with increased risk of CVD midlife. However, considered with conventional risk factors, history of HDP or having delivered LBW offspring did not meaningfully improve 10-year CVD risk prediction in women age 50 years or older. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s10654-018-0429-1) contains supplementary material, which is available to authorized users. Springer Netherlands 2018-07-30 2018 /pmc/articles/PMC6153555/ /pubmed/30062549 http://dx.doi.org/10.1007/s10654-018-0429-1 Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Cardiovascular Disease
Timpka, Simon
Fraser, Abigail
Schyman, Tommy
Stuart, Jennifer J.
Åsvold, Bjørn Olav
Mogren, Ingrid
Franks, Paul W.
Rich-Edwards, Janet W.
The value of pregnancy complication history for 10-year cardiovascular disease risk prediction in middle-aged women
title The value of pregnancy complication history for 10-year cardiovascular disease risk prediction in middle-aged women
title_full The value of pregnancy complication history for 10-year cardiovascular disease risk prediction in middle-aged women
title_fullStr The value of pregnancy complication history for 10-year cardiovascular disease risk prediction in middle-aged women
title_full_unstemmed The value of pregnancy complication history for 10-year cardiovascular disease risk prediction in middle-aged women
title_short The value of pregnancy complication history for 10-year cardiovascular disease risk prediction in middle-aged women
title_sort value of pregnancy complication history for 10-year cardiovascular disease risk prediction in middle-aged women
topic Cardiovascular Disease
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6153555/
https://www.ncbi.nlm.nih.gov/pubmed/30062549
http://dx.doi.org/10.1007/s10654-018-0429-1
work_keys_str_mv AT timpkasimon thevalueofpregnancycomplicationhistoryfor10yearcardiovasculardiseaseriskpredictioninmiddleagedwomen
AT fraserabigail thevalueofpregnancycomplicationhistoryfor10yearcardiovasculardiseaseriskpredictioninmiddleagedwomen
AT schymantommy thevalueofpregnancycomplicationhistoryfor10yearcardiovasculardiseaseriskpredictioninmiddleagedwomen
AT stuartjenniferj thevalueofpregnancycomplicationhistoryfor10yearcardiovasculardiseaseriskpredictioninmiddleagedwomen
AT asvoldbjørnolav thevalueofpregnancycomplicationhistoryfor10yearcardiovasculardiseaseriskpredictioninmiddleagedwomen
AT mogreningrid thevalueofpregnancycomplicationhistoryfor10yearcardiovasculardiseaseriskpredictioninmiddleagedwomen
AT frankspaulw thevalueofpregnancycomplicationhistoryfor10yearcardiovasculardiseaseriskpredictioninmiddleagedwomen
AT richedwardsjanetw thevalueofpregnancycomplicationhistoryfor10yearcardiovasculardiseaseriskpredictioninmiddleagedwomen
AT timpkasimon valueofpregnancycomplicationhistoryfor10yearcardiovasculardiseaseriskpredictioninmiddleagedwomen
AT fraserabigail valueofpregnancycomplicationhistoryfor10yearcardiovasculardiseaseriskpredictioninmiddleagedwomen
AT schymantommy valueofpregnancycomplicationhistoryfor10yearcardiovasculardiseaseriskpredictioninmiddleagedwomen
AT stuartjenniferj valueofpregnancycomplicationhistoryfor10yearcardiovasculardiseaseriskpredictioninmiddleagedwomen
AT asvoldbjørnolav valueofpregnancycomplicationhistoryfor10yearcardiovasculardiseaseriskpredictioninmiddleagedwomen
AT mogreningrid valueofpregnancycomplicationhistoryfor10yearcardiovasculardiseaseriskpredictioninmiddleagedwomen
AT frankspaulw valueofpregnancycomplicationhistoryfor10yearcardiovasculardiseaseriskpredictioninmiddleagedwomen
AT richedwardsjanetw valueofpregnancycomplicationhistoryfor10yearcardiovasculardiseaseriskpredictioninmiddleagedwomen