Ohseto Hisashi, Ishikuro Mami, Chen Geng, Takahashi Ippei, Shinoda Genki, Noda Aoi, Murakami Keiko, Orui Masatsugu, Iwama Noriyuki, Kikuya Masahiro, Metoki Hirohito, Hozawa Atsushi, Obara Taku, Kuriyama Shinichi
Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan.
Tohoku Medical Megabank Organization, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.
Sci Rep. 2025 May 29;15(1):18924. doi: 10.1038/s41598-025-03652-x.
Adverse pregnancy outcomes (APOs) affect approximately 20% pregnant women, and their incidence is increasing. The aim of this study was to investigate the effect of cardiovascular health (CVH) during pregnancy on APOs. We analyzed data from 14,930 pregnant women in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. CVH status during pregnancy was assessed using the eight components of Life's Essential 8. APOs were defined as composite outcomes encompassing preeclampsia, gestational diabetes mellitus, preterm birth, and small for gestational age. The numbers of participants with high, moderate, and low CVH status were 2891 (19.4%), 11,498 (77.0%), and 541 (3.6%), respectively. Poisson regression analyses with robust error variance, which adjusted for maternal age at conception, alcohol consumption, conception via in vitro fertilization, parity, psychological distress, social isolation, and household income, showed a positive association between moderate and low CVH levels and APOs (risk ratio and 95% confidence interval 1.15 [1.03-1.28] and 2.14 [1.78-2.58], respectively). Among pregnant women with low CVH, those who reported social isolation had a higher prevalence of APOs than did those without social isolation (36.4% vs. 27.4%). This difference was attenuated for pregnant women with high CVH status (13.6% vs. 13.1%). In conclusion, CVH status may be useful for assessing the risk of APOs. Socially isolated pregnant women are more vulnerable to the effects of low CVH status.
不良妊娠结局（APO）影响约20%的孕妇，且其发生率呈上升趋势。本研究的目的是调查孕期心血管健康（CVH）对APO的影响。我们分析了东北医学大数据库项目出生及三代队列研究中14930名孕妇的数据。使用生命基本八项的八个组成部分评估孕期的CVH状况。APO被定义为包括子痫前期、妊娠期糖尿病、早产和小于胎龄儿的综合结局。CVH状况高、中、低的参与者人数分别为2891人（19.4%）、11498人（77.0%）和541人（3.6%）。采用稳健误差方差的泊松回归分析，对受孕时的母亲年龄、饮酒情况、体外受精受孕、产次、心理困扰、社会隔离和家庭收入进行了调整，结果显示CVH水平中等和低与APO之间存在正相关（风险比和95%置信区间分别为1.15[1.03 - 1.28]和2.14[1.78 - 2.58]）。在CVH低的孕妇中，报告有社会隔离的孕妇APO患病率高于无社会隔离的孕妇（36.4%对27.4%）。对于CVH状况高的孕妇，这种差异有所减弱（13.6%对13.1%）。总之，CVH状况可能有助于评估APO的风险。社会隔离的孕妇更容易受到低CVH状况的影响。
