Department of Sleep Disorders, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China.
Hefei Fourth People's Hospital, Hefei, China.
Front Public Health. 2023 Apr 11;11:1071706. doi: 10.3389/fpubh.2023.1071706. eCollection 2023.
To estimate the association of previous pregnancy loss with subsequent cardiovascular health during gestation and to examine the role of high-sensitivity C reactive protein (hs-CRP) in the association.
A total of 2,778 nulliparous pregnant women were recruited between March 2015 and November 2020 in Hefei city, China. Their cardiovascular health (CVH) including prepregnancy body mass index (BMI), blood pressure, total cholesterol, fasting plasma glucose, and smoke status were recorded at 24-28 weeks' gestation, as well as their reproductive history. Multivariate linear and logistic regression were performed to examine the association of pregnancy loss with cardiovascular health. And the role of hs-CRP between pregnancy loss and CVH was assessed by the mediation analysis.
Compared with women who have no pregnancy loss, women with a history of spontaneous or induced abortions had higher BMI (, 0.72, 95% , 0.50 to 0.94) and fasting plasma glucose (, 0.04, 95% , 0.01 to 0.07), and had lower total CVH scores after adjusting for confounders (, -0.09, 95% , -0.18 to -0.01). CVH scores were most significantly decreased among women with 3 or more induced abortions (, -0.26, 95% , -0.49, -0.02). The contribution of pregnancy loss to poorer gestational CVH mediated by increased hs-CRP levels was 23.17%.
Previous pregnancy loss was associated with poorer cardiovascular health during gestation, which may be mediated by their gestational inflammatory status. Exposure to miscarriage alone was not a significant predictor of poorer CVH.
评估既往妊娠丢失与妊娠期间心血管健康的相关性，并探讨高敏 C 反应蛋白（hs-CRP）在该相关性中的作用。
2015 年 3 月至 2020 年 11 月，在中国合肥市招募了 2778 名初产妇。在 24-28 孕周时记录了她们的心血管健康（CVH），包括孕前体重指数（BMI）、血压、总胆固醇、空腹血糖和吸烟状况，以及她们的生殖史。采用多元线性和逻辑回归分析妊娠丢失与心血管健康的关系。采用中介分析评估 hs-CRP 在妊娠丢失与 CVH 之间的作用。
与无妊娠丢失的妇女相比，有自然流产或人工流产史的妇女 BMI（，0.72，95%CI：0.50 至 0.94）和空腹血糖（，0.04，95%CI：0.01 至 0.07）较高，调整混杂因素后总 CVH 评分较低（，-0.09，95%CI：-0.18 至 -0.01）。有 3 次或以上人工流产史的妇女 CVH 评分降低最为显著（，-0.26，95%CI：-0.49，-0.02）。hs-CRP 水平升高介导的妊娠丢失对妊娠期间较差 CVH 的贡献为 23.17%。
既往妊娠丢失与妊娠期间心血管健康较差相关，这可能与妊娠期间炎症状态增加有关。仅流产暴露并不是 CVH 较差的显著预测因素。
