Maternal risk of ischemic heart disease following elective and spontaneous preterm delivery: retrospective cohort study of 750,350 singleton pregnancies

Hastie, C.E., Smith, G.C.S., Mackay, D.F. and Pell, J.P. (2011) Maternal risk of ischemic heart disease following elective and spontaneous preterm delivery: retrospective cohort study of 750,350 singleton pregnancies. Obstetrical and Gynecological Survey, 66(12), pp. 745-746. (doi:10.1097/OGX.0b013e3182401d12)

Hastie, C.E., Smith, G.C.S., Mackay, D.F. and Pell, J.P. (2011) Maternal risk of ischemic heart disease following elective and spontaneous preterm delivery: retrospective cohort study of 750,350 singleton pregnancies. Obstetrical and Gynecological Survey, 66(12), pp. 745-746. (doi:10.1097/OGX.0b013e3182401d12)

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Publisher's URL: http://dx.doi.org/10.1097/OGX.0b013e3182401d12

Abstract

<p>A number of studies have demonstrated an association between preterm delivery and maternal risk of subsequent ischemic heart disease (IHD). The mechanism underlying this association is unknown, and it is also unknown whether the association is specific to either elective or spontaneous preterm delivery. Placental dysfunction (preeclampsia or intrauterine growth restriction) is an important risk factor for elective preterm delivery. Spontaneous preterm delivery has other causes and is frequently idiopathic.</p> <p>This retrospective study was designed to determine whether the risk for development of IHD after preterm delivery is specific for either elective or spontaneous delivery. Data for deliveries between 1969 and 2007 were obtained by linking 3 nationwide databases: Scottish Morbidity Record 2 (providing data on acute hospital admissions), Scottish Morbidity Record 1 (providing data on all pregnancies), and Scotland's Registrar General (providing data from all death certificates). Univariate and multivariate Cox proportional hazards models were used to examine associations between premature delivery and IHD deaths and events (fatal and nonfatal IHD). The study population comprised 750,350 women who delivered a live, singleton infant after their first pregnancy. All women in the cohort were between 35 and 65 years of age at either the time of their first IHD event or at the end of follow-up.</p> <p>Multivariate Cox analysis showed independent associations between preterm delivery and IHD death (hazards ratio, 2.26; 95% confidence interval, 1.88–2.71) and total IHD events (hazards ratio, 1.58; 95% confidence interval, 1.47–1.71). Greater associations were found for elective versus spontaneous preterm delivery (P = 0.005). There was evidence of an age-related interaction: a trend was observed for increasing association between preterm births and IHD events with decreasing age at first IHD event.</p> <p>These findings demonstrate a stronger relationship between elective preterm delivery and IHD than spontaneous preterm delivery and IHD. The age trend suggests an underlying genetic predisposition to IHD and placental dysfunction in premature delivery.</p>

Item Type:Articles (Editorial)
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Hastie, Dr Claire and Pell, Professor Jill and Mackay, Dr Daniel
Authors: Hastie, C.E., Smith, G.C.S., Mackay, D.F., and Pell, J.P.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:Obstetrical and Gynecological Survey
ISSN:0029-7828
ISSN (Online):1533-9866

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