Relationship between recurrent miscarriage and early preterm delivery and recurrent events in patients with manifest vascular disease: The SMART study.
Eur J Prev Cardiol
; 23(5): 486-92, 2016 Mar.
Article
em En
| MEDLINE
| ID: mdl-26130496
ABSTRACT
BACKGROUND:
Women with a complication of pregnancy are at increased risk of cardiovascular morbidity and mortality later in life. Yet, information on risk of recurrent events in women with a previous cardiovascular event is lacking. We aimed to assess the relationship between early preterm delivery, (recurrent) miscarriage and the risk for recurrent cardiovascular events in women with manifest vascular disease.METHODS:
We included 1014 women with a mean age of 60 years from the SMART study, a prospective ongoing cohort study among subjects with clinically manifest vascular disease. The included women had a history of ≥1 pregnancy and were followed for the occurrence of subsequent vascular events. The relationship between the pregnancy complications ((miscarriage (gestational age <14 weeks), recurrent miscarriage (≥3 miscarriages) and early preterm delivery (gestational age 14-32 weeks)) and cardiovascular morbidity and mortality were estimated using multivariable adjusted hazard ratios.RESULTS:
During a mean follow-up of 5.0 years, 80 women had a recurrent cardiovascular event, of which 28 were fatal. A history of recurrent miscarriage was associated with an increased risk for a recurrent cardiovascular event (hazard ratio 4.3 95% confidence interval 1.7--10.9). In addition, early preterm delivery was related to a 4.1 (95% confidence interval 1.5--11.3) fold increased risk of cardiovascular death in women with previous cardiovascular disease. No statistically significant relationships were found for less than three miscarriages.CONCLUSIONS:
In women with previous cardiovascular disease, an obstetric history of recurrent miscarriage is associated with an increased risk of recurrent cardiovascular morbidity and early preterm delivery with cardiovascular mortality.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Doenças Vasculares
/
Aborto Habitual
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Nascimento Prematuro
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article