Early or recurrent preterm birth and maternal cardiovascular disease risk.

Abstract:

PURPOSE:Preterm birth (PTB) has been associated with a later increased risk of maternal cardiovascular disease (CVD). We hypothesized a more pronounced relation between early or recurrent PTB and maternal CVD risk. METHODS:We related PTB severity (earlier gestational age at delivery) and recurrence (>/=2) among women with births from 1973-1983 in Denmark (n = 427,765) to maternal CVD morbidity or mortality (1977-2006). Birth data were linked to CVD hospitalizations and deaths identified in national registers and data were analyzed using Cox proportional hazards models. RESULTS:Women with a prior PTB had excess CVD after adjustment for age, parity, and education (hazard ratio [HR] = 1.36 [95% confidence interval (CI): 1.31, 1.41]). This was only modestly attenuated when women with preeclampsia or small for gestational age births were excluded, and the relationship was stronger for CVD mortality (HR = 1.98 [1.73, 2.26]). Recurrent PTB was associated with higher CVD morbidity compared to women with one PTB, particularly for ischemic events (HR = 1.78 [1.40, 2.27] vs. 1.22 [1.09, 1.36]). Risk was similarly elevated among women with early, moderate, and late PTB. Sensitivity analysis suggested that confounding by smoking only partly explained these associations. CONCLUSIONS:Women with PTB, especially recurrent PTB, were at increased risk for CVD, suggesting common causes of these conditions.

journal_name

Ann Epidemiol

journal_title

Annals of epidemiology

authors

Catov JM,Wu CS,Olsen J,Sutton-Tyrrell K,Li J,Nohr EA

doi

10.1016/j.annepidem.2010.05.007

subject

Has Abstract

pub_date

2010-08-01 00:00:00

pages

604-9

issue

8

eissn

1047-2797

issn

1873-2585

pii

S1047-2797(10)00118-3

journal_volume

20

pub_type

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