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An association between preterm delivery and long-term maternal cardiovascular morbidity
Open accessAbstract
Objective The purpose of this study was to investigate whether a history of preterm delivery (PTD) poses a risk for subsequent maternal long-term cardiovascular morbidity.Study design A population-based study compared the incidence of cardiovascular morbidity in a cohort of women who delivered preterm (<37 weeks' gestation) and those who gave birth at term at the same period. Deliveries occurred during the years 1988-1999 with follow up until 2010. Kaplan-Meier survival curves were used to estimate cumulative incidence of cardiovascular hospitalizations. Cox proportional hazards models were used to estimate the adjusted hazard ratios for cardiovascular hospitalizations.Results During the study period 47,908 women met the inclusion criteria; 12.5% of the patients (n = 5992) delivered preterm. During a follow-up period of >10 years, patients with PTD had higher rates of simple and complex cardiovascular events and higher rates of total cardiovascular-related hospitalizations. A linear association was found between the number of previous PTD and future risk for cardiovascular hospitalizations (5.5% for ≥2 PTDs; 5.0% for 1 PTD vs 3.5% in the comparison group; P < .001). The association remained significant for spontaneous vs induced PTD and for early (<34 weeks) and late (34 weeks to 36 weeks 6 days' gestation) PTD. In a Cox proportional hazards model that adjusted for pregnancy confounders such as labor induction, diabetes mellitus, preeclampsia, and obesity, PTD was associated independently with cardiovascular hospitalizations (adjusted hazard ratio, 1.4; 95% confidence interval, 1.2-1.6).Conclusion PTD is an independent risk factor for long-term cardiovascular morbidity in a follow-up period of more than a decade.
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“Furthermore, IVF may contribute to CVD risk through the development of hypertensive disorders of pregnancy such as pre-eclampsia, which is itself a potent sex-specific CVD risk factor (Central Illustration)(7).”
From Cardiovascular Risk Following Fertility Therapy (2017) · cites this paper as [7]
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Epidemiology and causes of preterm birth
Goldenberg, R. L., Culhane, J. F., Iams, J. D., & Romero, R. (2008) · The Lancet · doi:10.1016/s0140-6736(08)60074-4 · Cited by 7,801
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Placental bed disorders in preterm labor, preterm PROM, spontaneous abortion and abruptio placentae
Romero, R. J., Kusanovic, J. P., Chaiworapongsa, T., & Hassan, S. S. (2011) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2011.02.006 · Cited by 230
Birth Characteristics and Subsequent Risks of Maternal Cardiovascular Disease
Bonamy, A. E., Parikh, N. I., Cnattingius, S., Ludvigsson, J. F., & Ingelsson, E. (2011) · Circulation · doi:10.1161/circulationaha.111.034884 · Cited by 223
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Metadata
- Authors
- Kessous, R., Shoham-Vardi, I., Pariente, G., Holcberg, G., & Sheiner, E.
- Affiliations
- Ben-Gurion University of the Negev (IL)
- Corresponding author
- Sheiner, Eyal
- Venue
- American Journal of Obstetrics and Gynecology
- Publisher
- Elsevier BV
- Published
- 2013-10
- Volume
- 209
- Issue
- 4
- Pages
- 368.e1-368.e8
- ISSN
- 0002-9378 (ISSN-L)
- OpenAlex
- W2113893080
- Cited by
- 104
- References
- 20
- Citations by year
- 2026: 6 · 2025: 2 · 2024: 3 · 2023: 5 · 2022: 10 · 2021: 8 · 2020: 7 · 2019: 11 · 2018: 12 · 2017: 7 · 2016: 8 · 2015: 17 · 2014: 7 · 2013: 1
- FWCI
- 12.31
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Obstetrics and Gynecology › Preterm Birth and Chorioamnionitis
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Issues in Pregnancy
- Keywords
- preterm birth, cardiovascular hospitalization, long-term maternal health, risk factors, spontaneous preterm birth, gestational age at delivery
- MeSH terms
- Adult, Cardiovascular Diseases, Female, Follow-Up Studies, Hospitalization, Humans, Pregnancy, Retrospective Studies, Risk Factors, Cohort Studies, Proportional Hazards Models, Premature Birth, Kaplan-Meier Estimate, Young Adult
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