CV threat elements tied to adversarial being pregnant outcomes, gestational diabetes, hypertension

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March 07, 2021

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Catov and Pemberton do not report any relevant financial information. In the study you will find all relevant financial information from all other authors.

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CV risk factors have been linked to adverse pregnancy outcomes and gestational diabetes and high blood pressure 2 to 7 years after pregnancy, according to the results of the nuMoM2b heart health study.

“What we know about high blood pressure is that the sooner you get it, the worse your heart disease outcomes can be. If we can change this course and intervene sooner, for example after a woman has an unfavorable pregnancy outcome, then we are doing her a great service, ”said Victoria Pemberton, RNC, MS, nurse and researcher in the Department of Cardiovascular Sciences at NHLBI said in a press release. “Usually we think of women who are at risk for heart disease after menopause. We don’t think of young women who are in their reproductive years or who have babies who are at risk for high blood pressure. “

Pregnant women in the hospitalSource: Adobe Stock

Atherogenic markers

The study, published in the Journal of the American Heart Association, included 4,471 young pregnant women (mean age 27 years). Researchers evaluated atherogenic markers in the first trimester for adverse pregnancy outcomes, including hypertensive pregnancy disorders, premature births, and minor pregnancy disorders. Gestational diabetes; and high blood pressure 2 to 7 years after birth.

There were 1,102 women in the cohort with poor pregnancy outcomes and gestational diabetes. Compared to women without poor pregnancy outcomes and gestational diabetes, women with one or both of them were more likely to have obesity (34.2% versus 19.5%), higher systolic blood pressure (112.2 mm Hg versus 108.4 mm Hg), and higher diastolic blood pressure Blood pressure (69.2 mm Hg versus 66.6 mm Hg), higher glucose (5 mmol / l versus 4.8 mmol / l), higher insulin (77.6 pmol / l versus 60.1 pmol / l), higher Triglycerides (1.4 mmol / l versus 1.3) mmol / l), higher highly sensitive C-reactive protein levels (5.6 nmol / l versus 4 nmol / l) and lower HDL (1.8 mmol / l versus 1, 9 mmol / L; P <0.05 for all).

After delivery, women with poor pregnancy outcomes and gestational diabetes were more likely to develop hypertension than women without it (32.8% versus 18.1%; P <0.05), the researchers wrote.

Later high blood pressure

The researchers observed an association between later hypertension 2 to 7 years after birth and higher glucose (RR per 0.6 mmol / L = 1.03; 95% CI, 1-1.06), higher hsCRP (RR per two times higher Level = 1.06; 95% CI, 1.02) -1.11) and higher triglycerides (RR per two times higher level = 1.27; 95% CI, 1.14-1.41) after taking into account confounding factors and Factors assessed before birth. Higher physical activity protected against later hypertension (RR per 3 hours per week = 0.93; 95% CI, 0.87-0.99).

The 6.9% of women in the cohort who were not obese but had high levels of lipids, hsCRP, and insulin were at increased risk for undesirable pregnancy outcomes, gestational diabetes, and postpartum hypertension, and 7% to 15% of their excess RR were Outcomes associated with unwanted pregnancy and gestational diabetes, the researchers wrote.

“During pregnancy, women are in frequent contact with health care providers and undergo multiple health screening exams,” said Janet M. Catov, PhD, researcher at the University of Pittsburgh’s Magee-Women’s Research Institute, in the press release. “A strong provider-patient partnership can be a first step in identifying potential risks for pregnancy complications and developing strategies to support the cardiovascular health of a mother and her child for years to come.”

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