Abstract 1414 Association of adverse pregnancy outcomes with cardiovascular disease – lessons learned from the Hamburg City Health Study (HCHS)

Clin Res Cardiol (2023). https://doi.org/10.1007/s00392-023-02180-w
Association of adverse pregnancy outcomes with cardiovascular disease – lessons learned from the Hamburg City Health Study (HCHS)
N. Makarova¹, E. Unger², K. Borof³, G. Aarabi³, S. Blankenberg², M. Augustin⁴, C. Waldeyer⁵, E. Zengin-Sahm², C. Magnussen², C. Behrendt⁶, G. Thomalla⁷, R. Schnabel⁵, B.-C. Zyriax¹, für die Studiengruppe: HCHS
¹Hebammenwissenschaften - Versorgungsforschung - Prävention - Universitätsklinikum Hamburg-Eppendorf, Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Hamburg; ²Klinik für Kardiologie, Universitäres Herz- und Gefäßzentrum Hamburg, Hamburg; ³Zentrum für Zahn-, Mund- und Kieferheilkunde (ZMK) Poliklinik für Parodontologie, Präventive Zahnmedizin und Zahnerhaltung, Universitätsklinikum Hamburg-Eppendorf, Hamburg; ⁴Zentrum für Psychosoziale Medizin Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf, Hamburg; ⁵Allgemeine und Interventionelle Kardiologie, Universitäres Herz- und Gefäßzentrum Hamburg, Hamburg; ⁶Kardiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg; ⁷Kopf- und Neurozentrum Klinik und Poliklinik für Neurologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg;
Background: Increased cardiovascular risk in women in later life has been related to complications of pregnancy such as hypertension, diabetes, elevated body mass index and weight gain as well as to adverse pregnancy outcomes such as preterm birth, hysterectomy or ovariectomy. Methods: Using data from the large, monocenter, prospective, long-term, population-based cohort study from the metropolitan region of Hamburg, Germany (HCHS), we analysed self-reported data on pregnancy, risk factors as well as health status of 1,970 women. We examined the correlations between gestational hypertension (gHTN), gestational diabetes (gDM), weight gain during pregnancy and hypertension (HTN), diabetes (DM) and body mass index (BMI) in later life. Associations were assessed between current smoking status, hyperlipoproteinaemia (HLP) and weight gain during pregnancy. Regarding adverse pregnancy outcomes, we associated hyster- and ovariectomy with preterm birth and BMI with birth weight of >4,000 g. The Wilcoxon rank sum test and the Pearson's Chi-squared test were carried out to prove associations. The p-value of 0.05 was taken as a standard for significance. Results: The median age of 1,970 women upon examination was 63 years. The proportion of gestational hypertension was 8.7%, 18% gained more than 20 kg and 2.4 % had diabetes during pregnancy. 10% delivered newborns with a birth weight of <2,500 g. 14% delivered newborns with a birth weight of >4,000 g. 19% were smokers and have hyperlipoproteinaemia, 59% were hypertensive and 33% had metabolic syndrome. We found significant associations between gHTN, gDM, weight gain during pregnancy and HTN, DM and BMI. The association between current smoking status and weight gain during pregnancy was significant, the association between HLP and weight gain was not. We also found significant associations between elevated BMI and high birth weight of >4,000 g. Conclusions: In a population-based sample, we were able to demonstrate that pregnancy-related manifestations of cardiovascular risk factors are indeed related to an increased risk profile in later life. Further data is needed for individual risk stratification in women based on pregnancy-related data in order to deliver optimized early preventative strategies and potentially reduce cardiovascular events in later life.
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