Wu, P and Gulati, M and Kwok, CS and Wong, CW and Narain, A and O’Brien, S and Chew-Graham, CA and Verma, G and Kadam, U and Mamas, MA (2018) Preterm Delivery and Future Risk of Maternal Cardiovascular Disease: A Systematic Review and Meta-Analysis. Journal of the American Heart Association, 7 (2). ISSN 2047-9980

[img]
Preview
Text
e007809.full.pdf - Published Version
Available under License Creative Commons Attribution Non-commercial.

Download (2MB) | Preview

Abstract

Abstract Background - Preterm delivery (<37 weeks gestational age) affects 11% of all pregnancies, but data are conflicting whether preterm birth is associated with long-term adverse maternal cardiovascular outcomes. We aimed to systematically evaluate and summarize the evidence on the relationship between preterm birth and future maternal risk of cardiovascular diseases. Methods and Results - A systematic search of MEDLINE and EMBASE was performed to identify relevant studies that evaluated the association between preterm birth and future maternal risk of composite cardiovascular disease, coronary heart disease, stroke, and death due to cardiovascular or coronary heart disease and stroke. We quantified the associations using random effects meta-analysis. Twenty-one studies with over 5.8 million women, including over 338,000 women with previous preterm deliveries, were identified. Meta-analysis of studies that adjusted for potential confounders showed that preterm birth was associated with an increased risk of maternal future cardiovascular disease (risk ratio (RR) 1.43, 95% CI 1.18, 1.72), cardiovascular disease death (RR 1.78, 95% CI 1.42, 2.21), coronary heart disease (RR 1.49, 95% CI 1.38, 1.60), coronary heart disease death (RR 2.10, 95% CI 1.87, 2.36), and stroke (RR 1.65, 95% CI 1.51, 1.79). Sensitivity analysis showed that the highest risks occurred when the preterm deliveries occurred before 32 weeks gestation or were medically indicated. Conclusions - Preterm delivery is associated with an increase in future maternal adverse cardiovascular outcomes, including a two-fold increase in deaths due to coronary heart disease. These findings support the assessment of preterm delivery in cardiovascular risk assessment in women. Key Words: Pregnancy and postpartum, cardiovascular disease risk factors, coronary heart disease risk, stroke, long-term outcome

Item Type: Article
Additional Information: © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
Uncontrolled Keywords: cardiovascular disease risk factors, coronary heart disease risk, long-term outcome, pregnancy and postpartum, stroke
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC666 Diseases of the circulatory (Cardiovascular) system
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Depositing User: Symplectic
Date Deposited: 16 Nov 2017 10:29
Last Modified: 04 May 2018 08:20
URI: http://eprints.keele.ac.uk/id/eprint/4230

Actions (login required)

View Item View Item