History of preterm birth and subsequent cardiovascular disease: a systematic review

Abstract

A history of preterm birth (PTB) may be an important lifetime risk factor for cardiovascular disease (CVD) in women. We identified all peer-reviewed journal articles that met study criteria (English language, human studies, female, and adults ≥19 years old), that were found in the PubMed/MEDLINE databases, and that were published between Jan. 1, 1995, and Sept. 17, 2012. We summarized 10 studies that assessed the association between having a history of PTB and subsequent CVD morbidity or death. Compared with women who had term deliveries, women with any history of PTB had increased risk of CVD morbidity (variously defined; adjusted hazard ratio [aHR] ranged from 1.2e2.9; 2 studies), ischemic heart disease (aHR, 1.3e2.1; 3 studies), stroke (aHR, 1.7; 1 study), and atherosclerosis (aHR, 4.1; 1 study). Four of 5 studies that examined death showed that women with a history of PTB have twice the risk of CVD death compared with women who had term births. Two studies reported statistically significant higher risk of CVD—rerelated morbidity and death outcomes (variously defined) among women with —2 pregnancies that ended in PTBs compared with women who had at least 2 births but which ended in only 1 PTB. Future research is needed to understand the potential impact of enhanced monitoring of CVD risk factors in women with a history of PTB on risk of future CVD risk.

Impact of Immune Deficiency on Remodeling of Maternal Resistance Vasculature 4 Weeks Postpartum in Mice

“…Normal pregnancies are generally associated with very-low-long-term cardiovascular risks, while complicated pregnancies, including preeclampsia, 67-69 preterm birth, [70][71][72] gestational diabetes, 73 and high multiparity, 74 are associated with increased long-term risk for cardiovascular disease. The examination herein raises the possibility that analysis of PP structural vascular properties along with innate and adaptive immune parameters will inform refined studies in the human PP.…”

Delivery of a Small-For-Gestational-Age Infant and Risk of Maternal Cardiovascular Disease – A Population-Based Record Linkage Study

“…A range of socioeconomic, behavioural, and biological risk factors shape the distribution and development of CVD. In addition to established risk factors shared by both men and women (e.g., smoking, hypercholesterolaemia, hypertension), complications during pregnancy (including preeclampsia [2], miscarriage [3], preterm birth [4] and low birth weight or fetal growth restriction [5]) have been identified as gender-specific risk factors that may help identify women who are susceptible to premature CVD. This evidence is emerging in parallel with the increased appreciation of the burden of CVD in women [6], including in women aged 18-44 years, in whom CVD is the third leading cause of death [7].…”

DNA methylation provides insight into intergenerational risk for preterm birth in African Americans

“…Women who deliver preterm are at increased risk to develop cardiovascular and other chronic disorders as they age. [34][35][36][37][38][39][40][41][42] For example, a series of studies demonstrate that mothers who deliver very preterm are at subsequent risk for Type 2 diabetes. 38,43 The first, conducted primarily in Caucasian women from the Nurses' Health Study II, reports that women who deliver very early preterm are more likely to be diagnosed with Type 2 diabetes in the decade following pregnancy.…”