Cited by 204Pregnancy and preeclampsia studiesCardiovascular Issues in PregnancyPreterm Birth and Chorioamnionitis

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Preterm Delivery and Future Risk of Maternal Cardiovascular Disease: A Systematic Review and Meta‐Analysis

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Wu, Pensée, Gulati, Martha, Kwok, Chun Shing, Wong, Chun Wai, Narain, Aditya, O'Brien, Shaughn, Chew‐Graham, Carolyn A., Verma, Ganga, Kadam, Umesh T., Mamas, Mamas A.·2018·Journal of the American Heart Association

DOI 10.1161/jaha.117.007809PMC PMC5850169

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Abstract

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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Self-citation

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
ORCID: Kwok, Chun Shing
Narain, Aditya
Kadam, Umesh T.
Mamas, Mamas A.
Venue: Journal of the American Heart Association
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2018-01-23
Volume: 7
Issue: 2
ISSN: 2047-9980 (ISSN-L)
DOI: 10.1161/jaha.117.007809
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 › Obstetrics and Gynecology › 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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Preterm Delivery and Future Risk of Maternal Cardiovascular Disease: A Systematic Review and Meta‐Analysis

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