Cardiovascular risk factor burden and adverse pregnancy outcomes in women with cardiovascular disease

Introduction

We investigated associations between pre-conception cardiovascular risk factor burden and adverse pregnancy outcomes (APOs) in women with cardiovascular disease (CVD).

Methods

We created a patient registry from our cardio-obstetrics program. APOs were defined as intrauterine growth restriction (IUGR), hypertensive disorder of pregnancy (HDP), and pre-term birth.

Results

Analysis included 63 women. 42 (66.7 %) experienced no APOs, while 21 (33.3 %) did; 18 (28.6 %), 3 (4.8 %), and 12 (19.0 %) developed an HDP, IUGR, or delivered pre-term, respectively. Pre-conception risk burden was not a significant predictor of APO development (p = 0.139). However, patients with pre-term delivery had a significantly higher number of risk factors (p < 0.001), as did patients with chronic hypertension with superimposed HDP (p < 0.001).

Discussion

Women delivering pre-term have higher risk factor burdens. Since pre-term birth is associated with future CVD in women independent of cause, optimization of preconception cardiovascular health could help mitigate these risks in an already vulnerable population.