Pregnancy as an early stress test for cardiovascular and kidney disease diagnosis

Facca, Thais Alquezar; Kirsztajn, Gianna Mastroianni; Sabino, Amélia Rodrigues Pereira; Passos, Michelle Tiveron; Santos, Larissa Fatima; Famá, Eduardo Augusto Brosco; Nishida, Sônia K.; Sass, Nelson

doi:10.1016/j.preghy.2017.11.008

Cited by 28 publications

(18 citation statements)

References 26 publications

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“…Methods such as bioelectrical impedance analysis for the assessment of fat mass and fat-free mass in pregnant women in the body composition studies have been described. [30][31][32][33][34][35] Our study establishes that BIA is a feasible and reproducible method that can be used during pregnancy. We found pregnant women with FMP over 28% had a higher risk of developing GDM than women with normal FMP (adjusted OR 1.572, 95% CI 1.104-2.240).…”

Section: Dovepresssupporting

confidence: 58%

<p>The Body Composition in Early Pregnancy is Associated with the Risk of Development of Gestational Diabetes Mellitus Late During the Second Trimester</p>

Liu

Liu²,

Gao

et al. 2020

DMSO

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Objective: Gestational diabetes mellitus (GDM) causes both short-and long-term harm to mothers and fetuses. It is important to predict the occurrence of GDM as early as possible and take adequate measures to prevent it. The purpose of this study was to investigate the association between body composition of pregnant women in early pregnancy and the risk of GDM. Subjects and Methods: A total of 1318 pregnant women in the early stage of pregnancy were recruited from the Guiyang Maternal and Child Health Care Hospital. Detailed clinical data were recorded. Body composition was determined using the bioimpedance method at 13 weeks of gestation. The association between BMI before pregnancy (pre-BMI), fat mass percentage (FMP) and skeletal muscle mass percentage (SMMP) and the results of glucose tolerance screening in the second trimester of pregnancy were analyzed. Fat mass index (FMI) was calculated using fat mass in kilograms as measured using BIA at 13 weeks of pregnancy divided by the square of the woman's height in meters (kg/m 2) and was analyzed to determine the predictive effect of body fat on GDM. Results: Of the 1318 participants, 249 were diagnosed with GDM and 1069 with normal blood glucose. The FMI and FMP in GDM were higher than in NGT (P<0.001), while the SMMP in GDM was lower than in NGT (P<0.001). Overweight women (pre-BMI≥24kg/m 2) had a higher risk of developing GDM than women with normal pre-BMI (adjusted OR 2.604, 95% CI 1.846-3.673). Women with FMP greater than 28% had a higher risk of developing to GDM than women with normal-range FMP (adjusted OR 1.572, 95% CI 1.104-2.240). When FMI is used to predict the incidence of GDM, the area under the curve (AUC) is 65.8%, which is comparable to BMI (AUC=67.2%). Conclusion: Body composition early during gestation is associated with the risk of GDM. The fat mass index in early pregnancy is a predictor of GDM, and it could be an indicator of the efficacy of any intervention to reduce the risk of GDM.

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Section: Dovepresssupporting

confidence: 58%

<p>The Body Composition in Early Pregnancy is Associated with the Risk of Development of Gestational Diabetes Mellitus Late During the Second Trimester</p>

Liu

Liu²,

Gao

et al. 2020

DMSO

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“…Although traditional risk factors that affect both men and women (eg, tobacco use, overweight and obesity, and physical inactivity) explain most of the deaths from non-communicable diseases globally,2 increasing evidence suggests that reproductive factors unique to women are associated with a greater risk of death from non-communicable diseases. Even if reproductive events do not increase the risk of death from non-communicable diseases, they could be useful as an early stress test of underlying risk factors that cause adverse reproductive outcomes and death from non-communicable diseases 34…”

Section: Introductionmentioning

confidence: 99%

Association of spontaneous abortion with all cause and cause specific premature mortality: prospective cohort study

Wang

Mínguez-Alarcón

Gaskins

et al. 2021

BMJ

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Objective To investigate the association of spontaneous abortion with the risk of all cause and cause specific premature mortality (death before the age of 70). Design Prospective cohort study. Setting The Nurses’ Health Study II (1993-2017), United States. Participants 101 681 ever gravid female nurses participating in the Nurses’ Health Study II. Main outcomes measures Lifetime occurrence of spontaneous abortion in pregnancies lasting less than 6 months, determined by biennial questionnaires. Hazard ratios and 95% confidence intervals for all cause and cause specific premature death according to the occurrence of spontaneous abortion, estimated with time dependent Cox proportional hazards models. Results During 24 years of follow-up, 2936 premature deaths were recorded, including 1346 deaths from cancer and 269 from cardiovascular disease. Crude all cause mortality rates were comparable for women with and without a history of spontaneous abortion (1.24 per 1000 person years in both groups) but were higher for women experiencing three or more spontaneous abortions (1.47 per 1000 person years) and for women reporting their first spontaneous abortion before the age of 24 (1.69 per 1000 person years). The corresponding age adjusted hazard ratios for all cause premature death during follow-up were 1.02 (95% confidence interval 0.94 to 1.11), 1.39 (1.03 to 1.86), and 1.27 (1.11 to 1.46), respectively. After adjusting for confounding factors and updated dietary and lifestyle factors, the occurrence of spontaneous abortion was associated with a hazard ratio of 1.19 (95% confidence interval 1.08 to 1.30) for premature mortality during follow-up. The association was stronger for recurrent spontaneous abortions (hazard ratio 1.59, 95% confidence interval 1.17 to 2.15 for three or more spontaneous abortions; 1.23, 1.00 to 1.50 for two; and 1.16, 1.05 to 1.28 for one compared with none), and for spontaneous abortions occurring early in a woman’s reproductive life (1.32, 1.14 to 1.53 for age ≤23; 1.16, 1.01 to 1.33 for ages 24-29; and 1.12, 0.98 to 1.28 for age ≥30 compared with none). When cause specific mortality was evaluated, the association of spontaneous abortion with premature death was strongest for deaths from cardiovascular disease (1.48, 1.09 to 1.99). Spontaneous abortion was not related to premature death from cancer (1.08, 0.94 to 1.24). Conclusions Spontaneous abortion was associated with an increased risk of premature mortality, particularly death from cardiovascular disease.

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“…Indeed, pregnancy serves as a stress test that is characterized by cardiometabolic and renal overload. Women who had experienced pregnancy‐induced hypertension were found to exhibit an increased incidence of obesity, metabolic syndrome, and hypertension; early onset of hypertension; high estimated vascular age; and low estimated GFR, underlining the importance of pregnancy‐induced hypertension as a marker of future atherosclerotic morbidity. In another study, Cain et al .…”

Section: Discussionmentioning

confidence: 99%

Routine blood tests during pregnancy for predicting future increases in risk of cardiovascular morbidity

Bar-Asher

Shefer

Shoham‐Vardi

et al. 2018

Intl J Gynecology & Obste

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Pregnancy as an early stress test for cardiovascular and kidney disease diagnosis

Cited by 28 publications

References 26 publications

<p>The Body Composition in Early Pregnancy is Associated with the Risk of Development of Gestational Diabetes Mellitus Late During the Second Trimester</p>

<p>The Body Composition in Early Pregnancy is Associated with the Risk of Development of Gestational Diabetes Mellitus Late During the Second Trimester</p>

Association of spontaneous abortion with all cause and cause specific premature mortality: prospective cohort study

Routine blood tests during pregnancy for predicting future increases in risk of cardiovascular morbidity

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