(Press-News.org) Sophia Antipolis, 21 July 2021: A study of more than 18 million pregnancies has shown a strong and graded relationship between women's heart health and pregnancy outcomes. The research is published today in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology (ESC).1
The researchers examined the presence of four risk factors for cardiovascular disease in women prior to pregnancy: unhealthy body weight, smoking, hypertension and diabetes. The likelihood of key pregnancy complications - maternal intensive care unit (ICU) admission, preterm birth, low birthweight and foetal death - rose incrementally with the number of pre-pregnancy cardiovascular risk factors.
"Individual cardiovascular risk factors, such as obesity and hypertension, present before pregnancy have been associated with poor outcomes for both mother and baby," said study author Dr. Sadiya Khan, Northwestern University Feinberg School of Medicine, Chicago, US. "Our study now shows a dose-dependent relationship between the number of risk factors and several complications. These data underscore that improving overall heart health before pregnancy needs to be a priority."
The study was a cross-sectional analysis of maternal and foetal data from the US National Center for Health Statistics (NCHS), which collects information on all live births and foetal deaths after 20 weeks' gestation. Individual-level data was pooled from births to women aged 15 to 44 years from 2014 to 2018.
Information was collected on the presence or absence of four cardiovascular risk factors before pregnancy: body mass index (BMI; under 18.5 kg/m2 or over 24.9 kg/m2), smoking, hypertension and diabetes. Women were categorised as having 0, 1, 2, 3, or 4 risk factors. The researchers estimated the relative risks of maternal ICU admission, preterm birth (before 37 weeks), low birthweight (under 2500 g), and foetal death associated with risk factors (1, 2, 3, or 4) compared with no risk factors (0). All analyses were adjusted for maternal age at delivery, race/ethnicity, education, receipt of prenatal care, parity, and birth plurality.
A total of 18,646,512 pregnancies were included in the analysis. The average maternal age was 28.6 years. 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.
Compared to women with no pre-pregnancy risk factors, those with all four risk factors (3,242 women) had an approximately 5.8-fold higher risk for ICU admission, 3.9-fold higher risk for preterm birth, 2.8-fold higher risk for low birthweight, and 8.7-fold higher risk for foetal death.
There were graded associations between increasing numbers of pre-pregnancy risk factors and a higher likelihood of adverse outcomes. For example, compared to women with no risk factors, the risk ratio for maternal ICU admission was 1.12 for one risk factor, 1.86 for two risk factors, 4.24 for three risk factors, and 5.79 for four risk factors.
The analysis was repeated in women having their first baby (women with previous pregnancies were excluded) - with consistent results. "We conducted this analysis since women with a complicated first pregnancy are more likely to have complications in subsequent pregnancies," said Dr. Khan. "In addition, gestational weight gain can lead to a higher BMI going into the next pregnancy. We saw very similar results which strengthens the findings in the full cohort."
She continued: "Levels of pre-pregnancy obesity and high blood pressure are rising and there are some indications that women are acquiring cardiovascular risk factors at earlier ages than before. In addition, pregnancies are occurring 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."
Dr. Khan concluded: "The findings argue for more comprehensive pre-pregnancy cardiovascular assessment rather than focussing on individual risk factors, such as BMI or blood pressure, in isolation. In reality not all pregnancies are planned, but ideally we would evaluate women well in advance of becoming pregnant so there is time to optimise their health. We also need to shift our focus towards prioritising and promoting women's health as a society - so instead of just identifying hypertension, we prevent blood pressure from becoming elevated."
Authors: ESC Press Office
Tel: +33 (0)4 89 87 20 85
Mobile: +33 (0)7 8531 2036
Follow us on Twitter @ESCardioNews
Funding: The National Institutes of Health (P30AG059988 and P30DK092939) and the American Heart Association (#19TPA34890060) to S.K.
Disclosures: None declared.
1Wang MC, Freaney PM, Perak AM, et al. Association of pre-pregnancy cardiovascular risk factor burden with adverse maternal and offspring outcomes. Eur J Prev Cardiol. 2021. doi:10.1093/eurjpc/zwab121.
Link will go live on publication:
About the European Society of Cardiology
The European Society of Cardiology brings together health care professionals from more than 150 countries, working to advance cardiovascular medicine and help people lead longer, healthier lives.
About the European Journal of Preventive Cardiology
The European Journal of Preventive Cardiology is the world's leading preventive cardiology journal, playing a pivotal role in reducing the global burden of cardiovascular disease.
Any life identified on planets orbiting white dwarf stars almost certainly evolved after the star's death, says a new study led by the University of Warwick that reveals the consequences of the intense and furious stellar winds that will batter a planet as its star is dying. The research is published in Monthly Notices of the Royal Astronomical Society, and lead author Dr Dimitri Veras will present it today (21 July) at the online National Astronomy Meeting (NAM 2021).
The research provides new insight for astronomers searching for signs of life around these dead stars by examining the impact that their ...
Durham, Toronto and Princeton Universities have teamed up with NASA and the Canadian Space Agency to build a new kind of astronomical telescope. SuperBIT flies above 99.5% of the Earth's atmosphere, carried by a helium balloon the size of a football stadium. The telescope will make its operational debut next April and when deployed should obtain high-resolution images rivalling those of the Hubble Space Telescope. Mohamed Shaaban, a PhD student at the University of Toronto, will describe SuperBIT in his talk today (Wednesday 21 July) at the online RAS National Astronomy Meeting (NAM 2021).
Light from a distant galaxy can travel for billions of years to reach our telescopes. In the final ...
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 ...
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 . 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 ...