Preterm Delivery and Future Risk of Maternal Cardiovascular Disease: A Systematic Review and Meta‐Analysis
Open accessAbstract
Background: Preterm delivery (<37 weeks gestational age) affects 11% of all pregnancies, but data are conflicting whether preterm birth is associated with long‐term adverse maternal cardiovascular outcomes. We aimed to systematically evaluate and summarize the evidence on the relationship between preterm birth and future maternal risk of cardiovascular diseases. Methods and Results: A systematic search of MEDLINE and EMBASE was performed to identify relevant studies that evaluated the association between preterm birth and future maternal risk of composite cardiovascular disease, coronary heart disease, stroke, and death caused by cardiovascular or coronary heart disease and stroke. We quantified the associations using random effects meta‐analysis. Twenty‐one studies with over 5.8 million women, including over 338 000 women with previous preterm deliveries, were identified. Meta‐analysis of studies that adjusted for potential confounders showed that preterm birth was associated with an increased risk of maternal future cardiovascular disease (risk ratio [ RR ] 1.43, 95% confidence interval [CI], 1.18, 1.72), cardiovascular disease death ( RR 1.78, 95% CI , 1.42, 2.21), coronary heart disease ( RR 1.49, 95% CI , 1.38, 1.60), coronary heart disease death ( RR 2.10, 95% CI , 1.87, 2.36), and stroke ( RR 1.65, 95% CI , 1.51, 1.79). Sensitivity analysis showed that the highest risks occurred when the preterm deliveries occurred before 32 weeks gestation or were medically indicated. Conclusions: Preterm delivery is associated with an increase in future maternal adverse cardiovascular outcomes, including a 2‐fold increase in deaths caused by coronary heart disease. These findings support the assessment of preterm delivery in cardiovascular risk assessment in women.
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For subtypes of cardiovascular disease, the risk is increased in non-fatal stroke in women with preterm delivery.
“For subtypes of cardiovascular disease, the risk was increased in non-fatal ischaemic heart disease, fatal ischaemic heart disease, and non-fatal stroke.64”
From Association between the reproductive health of young women and cardiovascular disease in later life: umbrella review (2020) · cites this paper as [64]
For subtypes of cardiovascular disease, the risk is increased in non-fatal ischaemic heart disease in women with preterm delivery.
“For subtypes of cardiovascular disease, the risk was increased in non-fatal ischaemic heart disease, fatal ischaemic heart disease, and non-fatal stroke.64”
From Association between the reproductive health of young women and cardiovascular disease in later life: umbrella review (2020) · cites this paper as [64]
For subtypes of cardiovascular disease, the risk is increased in fatal ischaemic heart disease in women with preterm delivery.
“For subtypes of cardiovascular disease, the risk was increased in non-fatal ischaemic heart disease, fatal ischaemic heart disease, and non-fatal stroke.64”
From Association between the reproductive health of young women and cardiovascular disease in later life: umbrella review (2020) · cites this paper as [64]
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- Authors
- Wu, P., Gulati, M., Kwok, C. S., Wong, C. W., Narain, A., O'Brien, S., Chew‐Graham, C. A., Verma, G., Kadam, U. T., & Mamas, M. A.
- Affiliations
- University Hospitals of North Midlands NHS Trust (GB)
- University of Arizona (US)
- Keele University
- University of Leicester (GB)
- Corresponding author
- Wu, Pensée
- Venue
- Journal of the American Heart Association
- Published
- 2018-01-23
- Volume
- 7
- Issue
- 2
- ISSN
- 2047-9980 (ISSN-L)
- PMC
- PMC5850169
- OpenAlex
- W2784038503
- Cited by
- 204
- References
- 96
- Citations by year
- 2026: 28 · 2025: 20 · 2024: 24 · 2023: 33 · 2022: 30 · 2021: 24 · 2020: 28 · 2019: 11 · 2018: 6
- FWCI
- 2.78
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Journal of the American Heart Association (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Leicester Research Archive (University of Leicester) (submittedVersion, cc-by-nc-nd)
- Funders
- National Institute for Health and Care Research (TRF-2017-10-005, ACF-2013-06-001)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Issues in Pregnancy
- Health Sciences › Medicine › Epidemiology › Preterm Birth and Chorioamnionitis
- Keywords
- preterm birth, maternal cardiovascular disease, coronary artery disease, stroke, cardiovascular mortality, long-term maternal outcomes, cardiovascular risk assessment, gestational age
- MeSH terms
- Maternal Health, Adult, Cardiovascular Diseases, Female, Humans, Infant, Newborn, Pregnancy, Prognosis, Risk Factors, Time Factors, Risk Assessment, Premature Birth, Young Adult
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