(Press-News.org) CHICAGO --- A woman's heart health before she becomes pregnant is strongly related to her likelihood of experiencing a complication during her pregnancy or labor, reports a new Northwestern Medicine study.
The study examined the presence of four cardiovascular risk factors in women before they became pregnant: smoking, unhealthy body weight, hypertension and diabetes. With the presence of each additional risk factor, the likelihood that the woman would experience an adverse pregnancy outcome got increasingly higher. Those adverse outcomes include maternal intensive care unit (ICU) admission, preterm birth, low birthweight and fetal death.
"We're not surprised that obesity or hypertension are associated with higher risk of adverse pregnancy outcomes, but what is striking is that we found that with each additional risk factor, the risk of adverse pregnancy outcome gets successively higher," said corresponding author Dr. Sadiya Khan, assistant professor of medicine and of preventive medicine at Northwestern University Feinberg School of Medicine. "The sum of all the risk factors is greater than the individual parts."
The study of more than 18 million pregnancies will be published July 21 in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology.
The findings argue for more comprehensive pre-pregnancy cardiovascular assessment rather than focusing on individual risk factors, such as body mass index or blood pressure in isolation, said Khan, also a Northwestern Medicine cardiologist and epidemiologist.
"In reality, not all pregnancies are planned, but ideally we would evaluate women well in advance of becoming pregnant, so there is time to optimize their health," Khan said. "We also need to shift our focus toward prioritizing and promoting women's health as a society - so instead of just identifying hypertension, we prevent blood pressure from becoming elevated in the first place."
"There's a gap in understanding how these results affect longer-term health in women and their children," said first author Michael Wang, a fourth-year medical student at Feinberg. "This data is exciting because it will hopefully help in the design of interventions and focus greater attention on filling the care gap for these women."
A 'perfect storm' for pregnancy complications:
Levels of pre-pregnancy obesity and high blood pressure are rising, Khan said, and there are some indications women are acquiring cardiovascular risk factors at earlier ages than before. Additionally, more women are getting pregnant later in life, giving risk factors more time to accumulate.
"Taken together, this has created a perfect storm of more risk factors, earlier onset and later pregnancies," Khan said.
Breaking down the numbers:
The study was a cross-sectional analysis of maternal and fetal data from the U.S. National Center for Health Statistics (NCHS), which collects information on all live births and fetal deaths after 20 weeks' gestation. Individual-level data was pooled from births to women ages 15 to 44 from 2014 to 2018.
A total of 18,646,512 pregnancies were included in the analysis. The average maternal age was 28.6 years.
The scientists assigned women a risk factor score of 0-4 (0 for no risk factors or 4 for all four risk factors, for example). More than 60% of women had one or more pre-pregnancy cardiovascular risk factors, with 52.5%, 7.3%, 0.3%, and 0.02% having 1, 2, 3 and 4 risk factors, respectively.
The study found a graded association between a higher number of risk factors and the pregnancy being complicated by any of the four adverse outcomes. For example, compared to women with no risk factors, the risk ratio for maternal ICU admission was 1.12 times more likely to occur for one risk factor; 1.86 times more likely for two risk factors; 4.24 times more likely for three risk factors; and 5.79 times more likely for four risk factors.
All analyses were adjusted for maternal age at delivery, race/ethnicity, education, receipt of prenatal care, parity and birth plurality.
INFORMATION:
Other Northwestern co-authors on the study, "Association of pre-pregnancy cardiovascular risk factor burden with adverse maternal and offspring outcomes," include Dr. Priya Mehta Freaney, a fellow in the department of medicine at Feinberg, and Dr. Amanda Perak, assistant professor of pediatrics and preventive medicine at Feinberg.
Funding for this study was provided by the National Institute of Allergy and Infectious Diseases and the National Institute of Diabetes and Digestive and Kidney Diseases - both of the National Institutes of Health (grants P30AG059988 and P30DK092939) - and the American Heart Association (grant 19TPA34890060).
Contrary to what popular media portrays, we actually don't know much about what sharks eat. Even less is known about how they digest their food, and the role they play in the larger ocean ecosystem.
For more than a century, researchers have relied on flat sketches of sharks' digestive systems to discern how they function -- and how what they eat and excrete impacts other species in the ocean. Now, researchers have produced a series of high-resolution, 3D scans of intestines from nearly three dozen shark species that will advance the understanding of how sharks eat and digest their food.
"It's high time ...
Being more physically active and spending fewer hours per day sitting watching TV is linked to a substantially lower risk of developing obstructive sleep apnoea (OSA), according to new research published in the European Respiratory Journal [1]. It is the first study to simultaneously evaluate physical activity and sedentary behaviour in relation to OSA risk.
OSA is a condition where breathing stops and starts many times during sleep. It reduces oxygen levels in the blood and common symptoms include snoring, disrupted sleep and feeling excessively tired. ...
Study offers first global estimates of the number of children who experienced the death of a parent, grandparent, or primary caregiver from COVID-19.
Researchers estimated figures based on COVID-19 mortality data from March 2020 through April 2021, and national fertility statistics for 21 countries, and extrapolated findings to produce global estimates.
Findings suggest 1 million children have lost a parent, 1.1 million have lost a parent or custodial grandparent, and more than 1.5 million have lost a parent, custodial grandparent, or other secondary familial caregiver from COVID-19.
Authors call for urgent investments in services to support children who have lost their parents and caregivers.
An estimated ...
New research published in Anaesthesia (a journal of the Association of Anaesthetists) by researchers from the University of Bristol can help to improve the efficiency of surgery and help tackle the growing backlog of surgery caused by the COVID-19 pandemic. During the pandemic, the number of patients waiting for routine surgery in the UK has almost doubled with more than 5.3 million people awaiting surgery including more than 300,000 waiting more than a year.
A contributory factor is that COVID-19 precautions have led to many operating theatres working at 75-50% of normal working efficiency. Staff working in operating theatres have been required to take special precautions at the start and end of operations to allow viral particles ...
More than 1.5 million children around the world are estimated to have lost at least one parent, custodial grandparent, or grandparent who lived with them due to death related to COVID-19 during the first 14 months of the pandemic, according to a study published today in The Lancet. The study highlights orphanhood as an urgent and overlooked consequence of the pandemic and emphasizes that providing evidence-based psychosocial and economic support to children who have lost a caregiver must be a key part of responding to the pandemic.
The analysis used mortality and fertility data to model rates of COVID-19-associated orphanhood (death of one or both parents) and deaths of custodial and co-residing grandparents (ages 60-84) from March 1, 2020 to April 30, 2021, across 21 countries. This study ...
Metabolic bone diseases, including osteoporosis, when bones lose their mass and become so fragile that they could be damaged while sneezing or under little stress, are called the silent epidemic of the 21st century. A person does not even know about his illness before the first symptom - it can be a fracture of the spine or the neck of the hip. According to statistics, every third woman and every fifth man after 50 have osteoporosis. Thus, it is promising to search for and obtain substances and materials for implants that have osteoinductive properties and are capable of initiating the processes of transformation of stem cells into bone.
Certain trace elements, such as calcium and magnesium, influence the processes of bone regeneration ...
In the early days of the pandemic, scientists at Virginia Tech created a COVID-19 testing laboratory and novel test for the virus from scratch.
They not only developed a test in-house that avoided the reagent supply shortages that hampered testing efforts nationwide, but also used 3D-engineered supplies and stable storage media, enabling samples to be transported to rural sites in Virginia without the need for constant refrigeration.
This novel protocol for transforming a research laboratory into a testing operation capable of processing more than 130,000 ...
Spider silk is said to be one of the strongest, toughest materials on the Earth. Now engineers at Washington University in St. Louis have designed amyloid silk hybrid proteins and produced them in engineered bacteria. The resulting fibers are stronger and tougher than some natural spider silks.
Their research was published in the journal ACS Nano.
To be precise, the artificial silk -- dubbed "polymeric amyloid" fiber -- was not technically produced by researchers, but by bacteria that were genetically engineered in the lab of Fuzhong Zhang, a professor ...
ITHACA, N.Y. - Small-scale. Short-lived. All digital. Out of public view. That's how a new form of collective worker resistance is unfolding in China's app-based food delivery economy, new Cornell University research finds.
Though highly fragmented and not always successful, "mini-strikes" by small groups of food couriers - conducted via WeChat - reflect a new form of leverage, suggest Chuxuan "Victoria" Liu and Eli Friedman, associate professor in the ILR School.
Food couriers are able to maintain complete physical invisibility, and each individual worker can 'strike' from anywhere, they write.
The scholars interviewed couriers, in-person and online, who delivered food for Ele.me, an Alibaba-owned company that controlled ...
Tuesday, July 20, 2021, CLEVELAND: A Cleveland Clinic study demonstrates that adults with obesity lost significantly more weight when they had access to medications for chronic weight management in conjunction with their employer-based weight management program, compared to adults who did not have access to the medications. The study was published in JAMA Network Open.
Obesity is a complex disease that is caused by multiple factors, including genetic, environmental, and biological. A lifestyle intervention with a focus on nutrition and exercise is often not enough to treat obesity, which is a chronic disease that requires long-term therapy. The U.S. Food and Drug ...
