Impact of Obesity on Outcomes of Pregnancy in Women With Heart Disease.
J Am Coll Cardiol
; 77(10): 1317-1326, 2021 03 16.
Article
em En
| MEDLINE
| ID: mdl-33706874
ABSTRACT
BACKGROUND:
Women with heart disease are at risk for complications during pregnancy. This study sought to examine the effect of maternal obesity on pregnancy complications in women with heart disease.OBJECTIVES:
The objective was to determine the incidence of adverse cardiac events (CE) in pregnant women with heart disease and obesity.METHODS:
Adverse CE during pregnancy were examined in a prospective cohort of women with heart disease. CE were a composite of the following cardiac death/arrest, arrhythmias, heart failure, myocardial infarction, stroke, aortic dissection, and thromboembolic events. Pre-eclampsia and post-partum hemorrhage were also studied. Outcomes were examined according to body mass index (BMI). To identify additional predictors of CE, a baseline risk score (CARPREG [Canadian Cardiac Disease in Pregnancy Study] II score) for predicting cardiac complications was calculated for all pregnancies and included in a multivariable logistic regression model.RESULTS:
Of 790 pregnancies, 19% occurred in women with BMI ≥30 kg/m2 (obesity), 25% in women with BMI 25 to 29.9 kg/m2 (overweight), 53% in women with BMI 18.5 to 24.9 kg/m2 (normal weight), and 3% in women with BMI <18.5 kg/m2 (underweight). Women with obesity were at higher risk of CE when compared with women with normal weight (23% vs. 14%; p = 0.006). In a multivariable model, obesity (odds ratio 1.7; 95% confidence interval 1.0 to 2.7) and higher CARPREG II risk scores (odds ratio 1.7; 95% confidence interval 1.5 to 1.9) predicted CE. Pre-eclampsia was more frequent in women with obesity compared with those with normal weight (8% vs. 2%; p = 0.001).CONCLUSIONS:
Obesity increases the risk of maternal cardiovascular complications in pregnant women with heart disease. This modifiable risk factor should be addressed at the time of preconception counseling.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Complicações Cardiovasculares na Gravidez
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Resultado da Gravidez
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Cardiopatias
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Obesidade
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Newborn
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Pregnancy
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article