Does self-reported pregnancy loss identify women at risk of an adverse cardiovascular phenotype in later life? Insights from UK Biobank


Autoři: Einas Elmahi aff001;  Mihir M. Sanghvi aff002;  Alexander Jones aff003;  Christina Y. L. Aye aff001;  Adam J. Lewandowski aff001;  Nay Aung aff001;  Jackie A. Cooper aff001;  José Miguel Paiva aff001;  Elena Lukaschuk aff005;  Stefan K. Piechnik aff005;  Stefan Neubauer aff005;  Steffen E. Petersen aff002;  Paul Leeson aff001
Působiště autorů: Oxford Cardiovascular Clinical Research Facility, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, John Radcliffe, Oxford, United Kingdom aff001;  William Harvey Research Institute, NIHR Biomedical Research Centre at Barts, Queen Mary University of London, Charterhouse Square, London, Unite Kingdom, Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, London, Unite aff002;  Department of Paediatrics, Children’s Hospital, John Radcliffe, University of Oxford, Oxford, United Kingdom aff003;  The Nuffield Department of Women's & Reproductive Health, Medical Science Division, University of Oxford, Oxford, United Kingdom aff004;  Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom aff005
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0223125

Souhrn

Introduction

Cardiovascular disease (CVD) is more common in women who have had pregnancy complications such as spontaneous pregnancy loss. We used cross-sectional data from the UK Biobank Imaging Enhancement Study to determine whether pregnancy loss is associated with cardiac or vascular remodelling in later life, which might contribute to this increased risk.

Methods

Pregnancy history was reported by women participating in UK Biobank between 2006 and 2010 at age 40–69 years using a self-completed touch-screen questionnaire. Associations between self-reported spontaneous pregnancy loss and cardiovascular measures, collected in women who participated in the Imaging Enhancement Study up to the end of 2015, were examined. Cardiac structure and function were assessed by magnetic resonance (CMR) steady-state free precession imaging at 1.5 Tesla. Carotid intima-media thickness (CIMT) measurements were taken for both common carotid arteries using a CardioHealth Station. Statistical associations with CMR and carotid measures were adjusted for age, BMI and other cardiovascular risk factors.

Results

Data were available on 2660 women of whom 111 were excluded because of pre-existing cardiovascular disease and 30 had no pregnancy information available. Of the remaining 2519, 446 were nulligravid and 2073 had a history of pregnancies, of whom 622 reported at least one pregnancy loss (92% miscarriages and 8% stillbirths) and 1451 reported no pregnancy loss. No significant differences in any cardiac or carotid parameters were evident in women who reported pregnancy loss compared to other groups (Table 1).

Conclusion

Women who self-report pregnancy loss do not have significant differences in cardiac structure, cardiac function, or carotid structure in later life to explain their increased cardiovascular risk. This suggests any cardiovascular risks associated with pregnancy loss operate through other disease mechanisms. Alternatively, other characteristics of pregnancy loss, which we were not able to take account of, such as timing and number of pregnancy losses may be required to identify those at greatest cardiovascular risk.

Klíčová slova:

Blood pressure – Cardiovascular diseases – Cardiovascular diseases in women – Diabetes mellitus – Hypertensive disorders in pregnancy – Medical risk factors – Pregnancy – Pregnancy complications


Zdroje

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Článek vyšel v časopise

PLOS One


2019 Číslo 10