妊娠流产与中年妇女心血管疾病风险增加相关：来自中国健康与退休纵向研究的证据

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Global Heart Pub Date : 2025-01-09 eCollection Date: 2025-01-01 DOI:10.5334/gh.1386

Xiaoyan Yang, Qingling Fan, Can Shen, Ruirui Hou, Ruoling Chen, Jiaqian Yin, Huifeng Xiang, Yunxia Cao, Xiaoqing Peng

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引用次数: 0

摘要

目的：在西方国家已经发现流产与未来孕产妇心血管疾病（CVD）风险之间存在显著关联，但在中国这种关联尚不清楚。因此，本研究旨在探讨中国人群中妊娠丢失、妊娠丢失次数、妊娠丢失亚型（即人工流产、流产和死产）和首次妊娠丢失年龄与心血管疾病风险的关系。方法：我们分析了来自中国健康与退休纵向研究的7486名中年妇女（平均年龄58.1岁）的数据。流产和CVD包括冠心病（CHD）和中风是自我报告和记录在调查中。结果：在队列中，1,850名（24.7%）妇女经历了妊娠流产。在39年的随访中，2055名（27.5%）女性发展为心血管疾病。调整协变量后，流产与CVD风险相关（HR 1.73, 95% CI 1.56 ~ 1.92）。具体来说，流产和流产而非死产导致的妊娠损失增加了CVD （HR分别为2.11,95% CI 1.82 - 2.44和1.47,95% CI 1.16 - 1.72）。心血管疾病的风险从≤23岁逐渐增加到23-25岁、26-29岁和≥30岁，HR为1.29,95% CI为1.24 ~ 1.34。结论：由于人工流产和流产而流产的中国妇女发生心血管疾病的风险增加。风险随着流产次数和首次流产年龄的增加而增加。

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Pregnancy Loss Was Associated With the Increased Risk of Cardiovascular Diseases in Middle-Aged Women: Evidence From the China Health and Retirement Longitudinal Study.

Objectives: Significant associations between pregnancy loss and risk of future maternal cardiovascular disease (CVD) have been found in Western countries, but the association in China is still unclear. Therefore, this study aimed to investigate the associations of pregnancy loss, number of pregnancy losses, subtype of pregnancy loss (i.e. induced abortion, miscarriage and stillbirth) and age at the first pregnancy loss with CVD risk in Chinese population.

Methods: We examined data of 7,486 middle-aged women (mean age 58.1 years) from the China Health and Retirement Longitudinal Study. Pregnancy loss and CVD including coronary heart disease (CHD) and stroke were self-reported and documented in surveys.

Results: In the cohort, 1,850 (24.7%) women experienced pregnancy loss. Over 39 years follow-up, 2,055 (27.5%) women developed CVD. After adjusting covariates, pregnancy loss was associated with the risk of CVD (HR 1.73, 95% CI 1.56 to 1.92). Specifically, pregnancy loss due to induced abortion and miscarriage instead of stillbirth increased CVD (HR 2.11, 95% CI 1.82 to 2.44, and 1.47, 95% CI 1.16 to 1.72, respectively). The risk of CVD gradually increased from ≤23 years to 23-25, 26-29 and ≥30 years with HR 1.29, 95% CI 1.24 to 1.34.

Conclusion: Chinese women that have experienced pregnancy loss due to induced abortion and miscarriage had increased risk of CVD. The risk increased with the number of pregnancy losses and older age at the first pregnancy loss.

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来源期刊

Global Heart Medicine-Cardiology and Cardiovascular Medicine

CiteScore

5.70

自引率

5.40%

发文量

审稿时长

5 weeks

期刊介绍： Global Heart offers a forum for dialogue and education on research, developments, trends, solutions and public health programs related to the prevention and control of cardiovascular diseases (CVDs) worldwide, with a special focus on low- and middle-income countries (LMICs). Manuscripts should address not only the extent or epidemiology of the problem, but also describe interventions to effectively control and prevent CVDs and the underlying factors. The emphasis should be on approaches applicable in settings with limited resources. Economic evaluations of successful interventions are particularly welcome. We will also consider negative findings if important. While reports of hospital or clinic-based treatments are not excluded, particularly if they have broad implications for cost-effective disease control or prevention, we give priority to papers addressing community-based activities. We encourage submissions on cardiovascular surveillance and health policies, professional education, ethical issues and technological innovations related to prevention. Global Heart is particularly interested in publishing data from updated national or regional demographic health surveys, World Health Organization or Global Burden of Disease data, large clinical disease databases or registries. Systematic reviews or meta-analyses on globally relevant topics are welcome. We will also consider clinical research that has special relevance to LMICs, e.g. using validated instruments to assess health-related quality-of-life in patients from LMICs, innovative diagnostic-therapeutic applications, real-world effectiveness clinical trials, research methods (innovative methodologic papers, with emphasis on low-cost research methods or novel application of methods in low resource settings), and papers pertaining to cardiovascular health promotion and policy (quantitative evaluation of health programs.