History of Adverse Pregnancy Outcomes Linked to Coronary Artery Disease

FRIDAY, March 17, 2023 (HealthDay News) -- There is a significant association between a history of adverse pregnancy outcomes and later image-identified coronary artery disease, according to a study published in the Feb. 7 issue of the Journal of the American Medical Association.

Sofia Sederholm Lawesson, M.D., Ph.D., from Linköping University Hospital in Sweden, and colleagues examined the associations between a history of adverse pregnancy outcomes (preeclampsia, gestational hypertension, preterm delivery, small-for-gestational-age infant, and gestational diabetes) and later coronary artery disease assessed by coronary computed tomography angiography screening. Data were included for a population-based cohort of 10,528 women in Sweden with one or more deliveries in 1973 or later who subsequently participated in the Swedish Cardiopulmonary Bioimage Study at age 50 to 65 years from 2013 to 2018.

The researchers found that 18.9 percent of women had a history of adverse pregnancy outcome, with specific pregnancy histories varying from 1.4 percent for gestational diabetes to 9.5 percent for preterm delivery. For women with any adverse pregnancy outcome, the prevalence of any coronary atherosclerosis was 32.1 percent, which was significantly higher than among reference women without a history of adverse pregnancy outcome (prevalence ratio, 1.14). A history of gestational hypertension and preeclampsia were both associated with a similarly increased prevalence of all outcomes. In adjusted models, the odds ratios for preeclampsia ranged from 1.31 to 2.21 for any coronary atherosclerosis to significant stenosis, respectively. Women with low predicted cardiovascular risk had similar associations for a history of preeclampsia or gestational hypertension.

"Our results suggest that the correlation exists even among women with a low expected risk of cardiovascular disease," a coauthor said in a statement. "The study is an important piece of the puzzle in understanding how women with pregnancy complications should be followed-up by their health care provider after pregnancy."

Several authors disclosed financial ties to the pharmaceutical industry.

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