University of Kentucky, College of Public Health, Lexington, Kentucky, USA.
J Womens Health (Larchmt). 2011 Feb;20(2):287-93. doi: 10.1089/jwh.2010.2097. Epub 2011 Jan 25.
This study investigates the association between a prior history of pregnancy complications and cardiovascular disease (CVD) among Kentucky women aged ≥50 years.
Data were analyzed from participants (n = 3909) in the Kentucky Women's Health Registry (2006-2008). Primary outcomes were self-reported prevalence of CVD, including angina, heart attack, heart failure, and arrhythmia. Pregnancy complications used as predictors were preterm labor, preeclampsia, gestational diabetes mellitus (GDM), and third trimester bleeding. Logistic regression analyses were conducted to determine associations between prevalence of CVD and pregnancy complications, controlling for age, education, and smoking status.
Overall, 199 (5.1%) women reported angina, 79 (2.0%) reported heart attack, 44 (1.1%) reported heart failure, and 642 (16.4%) reported arrhythmia. One pregnancy complication was reported by 614 (15.7%) women, and two or more complications were reported by 130 (3.3%) women. In regression models adjusting for age, education, and smoking, compared to women who were never pregnant, women with no pregnancy complications had a similar risk of reporting heart attack (odds ratio [OR] 1.2, 95% confidence interval [CI] 0.5-2.7), but women with one pregnancy complication (OR 2.5, 95% CI 1.03-6.0) and two or more complications (OR 4.2, 95% CI 1.4-10.6) had an increased risk. Similar results were seen for angina and arrhythmia, but not heart failure.
Women who experience pregnancy complications are more likely to report prevalent CVD (including angina, heart attack, and arrhythmia), suggesting a link between adverse pregnancy events and CVD. Pregnancy complications may serve as signals for future CVD, presenting an opportunity for early intervention and prevention.
本研究旨在调查肯塔基州≥50 岁女性中既往妊娠并发症与心血管疾病（CVD）之间的关联。
对肯塔基州妇女健康登记处（2006-2008 年）的参与者（n=3909）进行数据分析。主要结局是自我报告的 CVD 患病率，包括心绞痛、心脏病发作、心力衰竭和心律失常。用作预测因子的妊娠并发症为早产、子痫前期、妊娠期糖尿病（GDM）和孕晚期出血。采用 logistic 回归分析来确定 CVD 患病率与妊娠并发症之间的关联，同时控制年龄、教育程度和吸烟状况。
共有 199 名（5.1%）女性报告心绞痛，79 名（2.0%）报告心脏病发作，44 名（1.1%）报告心力衰竭，642 名（16.4%）报告心律失常。614 名（15.7%）女性报告有一种妊娠并发症，130 名（3.3%）女性报告两种或更多种并发症。在调整年龄、教育程度和吸烟状况的回归模型中，与从未怀孕的女性相比，没有妊娠并发症的女性报告心脏病发作的风险相似（比值比[OR]1.2，95%置信区间[CI]0.5-2.7），但有一种妊娠并发症（OR 2.5，95%CI 1.03-6.0）和两种或更多种并发症（OR 4.2，95%CI 1.4-10.6）的女性发生风险增加。对于心绞痛和心律失常也有类似的结果，但对于心力衰竭则不然。
经历过妊娠并发症的女性更有可能报告 CVD 患病率（包括心绞痛、心脏病发作和心律失常），这表明不良妊娠事件与 CVD 之间存在关联。妊娠并发症可能是未来 CVD 的信号，为早期干预和预防提供了机会。
