School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
PLoS One. 2022 Dec 1;17(12):e0277320. doi: 10.1371/journal.pone.0277320. eCollection 2022.
Pregnancy loss, including miscarriage and stillbirth, affects 15-20% of pregnancies in the United States (US) annually. Accumulating evidence suggests that pregnancy loss is associated with a greater cardiovascular disease (CVD) burden later in life. However, few studies have evaluated the impact of pregnancy loss on CVD risk factors in early adulthood (age <35 years). The aim of this study was to examine associations between pregnancy loss and CVD risk factors (body mass index, blood pressure, hyperlipidemia, diabetes status) in early adulthood. We conducted a cross-sectional analysis using the public-use dataset for Wave IV (2007-2009) of the National Longitudinal Study of Adolescent to Adult Health (Add Health). Our sample consisted of women, ages 24-32 years, with a previous pregnancy who completed biological data collection (n = 2,968). Pregnancy loss was assessed as any history of miscarriage or stillbirth; and quantified as none, one, or recurrent (≥2) pregnancy loss. Associations between pregnancy loss and each CVD risk factor were tested using linear and logistic regression adjusting for sociodemographic factors, parity, health behaviors during pregnancy, and depression. We tested for interactions with race/ethnicity. A total of 670 women reported a pregnancy loss, of which 28% reported recurrent pregnancy loss. A prior pregnancy loss was related to a 3.79 (kg/mm2) higher BMI in non-Hispanic Black women, but not white women. Women with recurrent pregnancy loss were more likely to have prediabetes (AOR, 1.93; 95% CI, 1.10-3.37, p<0.05) than women with all live births. Findings suggest that pregnancy loss may be associated with a more adverse CVD risk profile in early adulthood, particularly for women who experience recurrent pregnancy loss. This highlights the need for CVD risk assessment in young women with a prior pregnancy loss. Further research is necessary to identify underlying risk factors of pregnancy loss that may predispose women to CVD.
妊娠丢失，包括流产和死胎，每年影响美国（US）15-20%的妊娠。越来越多的证据表明，妊娠丢失与以后生活中的心血管疾病（CVD）负担增加有关。然而，很少有研究评估妊娠丢失对青年早期（<35 岁）CVD 风险因素的影响。本研究旨在探讨妊娠丢失与青年早期 CVD 风险因素（体重指数、血压、血脂异常、糖尿病状况）之间的关系。我们使用国家青少年至成人健康纵向研究（Add Health）的第四波（2007-2009 年）的公开数据集进行了横断面分析。我们的样本包括年龄在 24-32 岁之间、有过妊娠且完成了生物数据采集的女性（n=2968）。妊娠丢失被评估为任何流产或死胎史；并量化为无、一或多次（≥2）妊娠丢失。使用线性和逻辑回归，调整社会人口统计学因素、产次、妊娠期间的健康行为和抑郁，检验妊娠丢失与每种 CVD 风险因素之间的关系。我们检验了种族/民族的交互作用。共有 670 名女性报告了妊娠丢失，其中 28%报告了多次妊娠丢失。先前的妊娠丢失与非西班牙裔黑人女性的 BMI 高 3.79（kg/mm2）有关，但与白人女性无关。有多次妊娠丢失的女性更有可能患有前驱糖尿病（AOR，1.93；95%CI，1.10-3.37，p<0.05），而不是所有活产的女性。研究结果表明，妊娠丢失可能与青年早期更不利的 CVD 风险状况有关，特别是对于经历多次妊娠丢失的女性。这凸显了对有过妊娠丢失的年轻女性进行 CVD 风险评估的必要性。需要进一步研究以确定可能使女性易患 CVD 的妊娠丢失的潜在风险因素。
