Risks of cardiovascular diseases increase with severity of prematurity

Mothers who deliver low-birth weight infants are at increased risks of cardiovascular diseases (CVD) later in life. This according to a new study at Karolinska Institutet, published online in the science magazine Circulation.

Previous studies show that low birth weight is associated with an increased risk of later maternal cardiovascular disease (CVD). Earlier studies also indicate that preterm delivery (ie, before 37 weeks) may be associated with an increased maternal CVD risk.

Researchers at Karolinska Institutet examined the association between severity of preterm birth, fetal growth restriction, and later maternal incident hospitalization or death from coronary heart disease, heart failure, and cerebrovascular events taking measured potential confounders into account. The study included 923 686 Swedish women giving their first singleton birth between 1983 and 2005.

After accounting for maternal age, birth year, income, education, smoking, hypertension, and diabetes mellitus, researchers found that the risk for CVD was more than doubled in women delivering very or extremely preterm (before 32 and 28 weeks, respectively) compared with women delivering a term, non-small-for-gestational-age infant. In women delivering a small-for-gestational-age infant, the CVD risk was doubled if the infant was born at 32 to 36 weeks and tripled if the infant was born before 32 weeks of gestation compared with women delivering a nonsmall infant at term.

In analyses restricted to women for whom prepregnancy body mass index data were available (N=670 934), additional adjustment for body mass index did not attenuate the CVD risk. Findings suggest that a preterm or small-for-gestational-age birth is an early indicator of later maternal CVD risk. If primary cardiovascular prevention measures are undertaken in women with a history of a preterm or small-for-gestational age birth, it might lower their CVD risk and improve the outcome of the next pregnancy.

Anna-Karin Edstedt Bonamy, Nisha I. Parikh, Sven Cnattingius, Jonas F. Ludvigsson and Erik Ingelsson.

Birth Characteristics and Subsequent Risks of Maternal Cardiovascular Disease: Effects of Gestational Age and Fetal Growth.

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