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Prepregnancy CV Risk Factors Prevalent, Tied to Adverse Outcomes

Consistent, marked graded association seen between greater prepregnancy risk factor burden and risk for adverse maternal, fetal outcomes

FRIDAY, July 30, 2021 (HealthDay News) — Prepregnancy cardiovascular risk factors are highly prevalent and are associated with adverse maternal and fetal outcomes, according to a research letter published online July 20 in the European Journal of Preventive Cardiology.

Michael C. Wang, from Northwestern University Feinberg School of Medicine in Chicago, and colleagues pooled individual-level data for 18,646,512 pregnancies to examine the impact of four prepregnancy cardiovascular risk factors (body mass index <18.5 kg/m2 or >24.9 kg/m2, smoking, hypertension, and diabetes) on maternal and neonatal morbidity and mortality.

The researchers found that over 60 percent of women had at least one prepregnancy cardiovascular risk factor (52.5, 7.3, 0.3, and 0.02 percent had one, two, three, and four, respectively). Women with one or more risk factors had less receipt of prenatal care, higher prevalence of multiparity, and higher prevalence of prior spontaneous or induced pregnancy loss compared with women with no risk factors. Consistent and marked graded associations were seen between greater prepregnancy risk factor burden and higher risk of adverse maternal and fetal outcomes (for example: risk ratios of maternal intensive care unit admission: 1.12, 1.86, 4.24, and 5.79 with one, two, three, and four risk factors, respectively, versus zero risk factors). Similar results were seen for preterm birth, low birth weight, and fetal death.

“Our data extend prior findings by validating the importance of the prepregnancy cardiovascular risk factor profile for risks of several key adverse maternal and offspring outcomes, which are known to influence the risk of subsequent cardiovascular disease,” the authors write.

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