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Associations of Pregnancy Complications With Calculated Cardiovascular Disease Risk and Cardiovascular Risk Factors in Middle Age: The Avon Longitudinal Study of Parents and Children
Open accessAbstract
Background—: The nature and contribution of different pregnancy-related complications to future cardiovascular disease (CVD) and its risk factors and the mechanisms underlying these associations remain unclear. Methods and Results—: We studied associations of pregnancy diabetes mellitus, hypertensive disorders of pregnancy, preterm delivery, and size for gestational age with calculated 10-year CVD risk (based on the Framingham score) and a wide range of cardiovascular risk factors measured 18 years after pregnancy (mean age at outcome assessment, 48 years) in a prospective cohort of 3416 women. Gestational diabetes mellitus was positively associated with fasting glucose and insulin, even after adjustment for potential confounders, whereas hypertensive disorders of pregnancy were associated with body mass index, waist circumference, blood pressure, lipids, and insulin. Large for gestational age was associated with greater waist circumference and glucose concentrations, whereas small for gestational age and preterm delivery were associated with higher blood pressure. The association with the calculated 10-year CVD risk based on the Framingham prediction score was odds ratio 1.31 (95 confidence interval, 1.11–1.53) for preeclampsia and 1.26 (95 confidence interval, 0.95–1.68) for gestational diabetes mellitus compared with women without preeclampsia and without gestational diabetes mellitus, respectively. Conclusions—: Hypertensive disorders of pregnancy and pregnancy diabetes mellitus are independently associated with an increased calculated 10-year CVD risk. Preeclampsia may be the better predictor of future CVD because it was associated with a wider range of cardiovascular risk factors. Our results suggest that pregnancy may be an important opportunity for early identification of women at increased risk of CVD later in life.
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“Adverse pregnancy outcomes are associated with long-term effects on health, for example, hypertensive disorders of pregnancy (HDP) and gestational diabetes (GDM) are independently associated with an increased risk for cardiovascular disease and type II diabetes [2].”
From Associations between periconceptional lifestyle behaviours and adverse pregnancy outcomes (2021) · cites this paper as [2]
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“Metabolic derangements linked to the risk of cardiovascular disease, including weight gain, decreased insulin sensitivity, dyslipidaemia, and hypertension, are prevalent in women with risk factors for cardiovascular disease specific to women”
From Association between the reproductive health of young women and cardiovascular disease in later life: umbrella review (2020) · cites this paper as [142]
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Cited by
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Cohort Profile: The Avon Longitudinal Study of Parents and Children: ALSPAC mothers cohort
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Self-citation
Metadata
- Authors
- Fraser, A., Nelson, S. M., Macdonald-Wallis, C., Cherry, L., Butler, E., Sattar, N., & Lawlor, D. A.
- Affiliations
- British Heart Foundation (GB)
- Venue
- Circulation
- Published
- 2012-03-20
- Volume
- 125
- Issue
- 11
- Pages
- 1367-1380
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- PMC
- PMC3323835
- OpenAlex
- W2022188664
- Cited by
- 401
- References
- 22
- Citations by year
- 2026: 17 · 2025: 19 · 2024: 31 · 2023: 21 · 2022: 23 · 2021: 28 · 2020: 33 · 2019: 27 · 2018: 32 · 2017: 35 · 2016: 30 · 2015: 28 · 2014: 31 · 2013: 35 · 2012: 11
- FWCI
- 39.95
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Explore Bristol Research (submittedVersion)
- Funders
- Wellcome Trust (84937, 076467/Z/05/Z, WT076467, 092731, 087997, WT087997)
- British Heart Foundation (SP/07/008/24066, PG/11/33/28794)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK077659)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- pregnancy complications, cardiovascular risk, gestational diabetes mellitus, hypertensive disorders of pregnancy, preeclampsia, preterm birth, large for gestational age, small for gestational age, cardiovascular risk factors, Framingham risk score, middle age (human life stage), fasting blood glucose, insulin, blood pressure, body mass index, waist circumference, serum lipids
- MeSH terms
- Adult, Age Factors, Child, Female, Follow-Up Studies, Humans, Longitudinal Studies, Middle Aged, Pre-Eclampsia, Pregnancy, Pregnancy Complications, Cardiovascular, Prospective Studies, Risk Factors, Cohort Studies, Diabetes, Gestational, Premature Birth
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