Cardiovascular Prevention and Pharmacotherapy

Review Article

Pregnancy at Late Maternal Age and Future Cardiovascular Health: Mi-Jeong Kim; Cardiovasc Prev Pharmacother. 2019;1(2):50-56. Published online October 31, 2019; DOI: https://doi.org/10.36011/cpp.2019.1.e9

Abstract PDF: Increasing numbers of women are delivering their first child at a later age. First pregnancy at a later age is, per se, a high-risk pregnancy. Pregnancy after 35 years is traditionally considered a late maternal age. The risks of obstetric complications including fetal and maternal complications are increased. Defective placenta syndrome, including hypertensive disorders, preterm birth, and intrauterine growth retardation, shares similar pathophysiologic mechanisms with endothelial dysfunction, although their clinical presentations differ. Recent medical advances have improved the medical performance of pregnancy-related cardiovascular disease (CVD). Recent evidence has shown that women with underlying defective placental syndrome or other pregnancy-related complications have an increased risk of unfavorable cardiovascular outcomes in later life. An increasing number of women delivering their first child at a later age have epidemiological characteristics that differ from those reported previously and for which data are limited data regarding the cardiovascular prognosis. Therefore, increased attention to public health and CVD prevention is required for women with complicated pregnancies.

Original Article

Preterm Labor and Later Maternal Cardiovascular Disease in General Population: Doubtful Relationship with Atherosclerosis: Mi-Jeong Kim, Hae Ok Jung, Sung Ha Chun, Hyeon Woo Yim, Doo Soo Jeon; Cardiovasc Prev Pharmacother. 2019;1(2):71-78. Published online October 31, 2019; DOI: https://doi.org/10.36011/cpp.2019.1.e10

Abstract PDF: Background
The maternal cardiovascular system experiences an enormous challenge during pregnancy. A history of preterm labor suggestive of dysfunctional pregnancy might be associated with the maternal later life chronic cardiovascular disease (CVD). We evaluated the association between preterm labor and the late development of maternal atherosclerotic CVD using the national database of general population.
Methods
Data for 5,226 postmenopausal women aged ≥50 years were analyzed from the Korean National Health and Nutrition Examination Survey V, which had conducted from 2010 to 2012.
Results
The numbers of preterm labor and CVD (stroke, myocardial infarction, or angina pectoris) were 151 (3.0±0.3%) and 367 (6.6±0.4%), respectively. In a multivariate analysis, CVD was independently associated with age (odds ratio [OR], 1.9; 95% confidence interval [CI], 1.8–2.0), the presence of hypertension (OR, 1.9; 95% CI,1.5–2.3), diabetes (OR, 2.3; 95% CI, 1.8–2.9), chronic kidney disease (OR, 1.8; 95% CI, 1.4–2.2) and low high-density lipoprotein cholesterol concentration (OR, 0.8; 95% CI, 0.7–0.9) were independently associated with CVD. A history of preterm labor was not associated with CVD (OR, 1.5; 95% CI, 0.6–3.8).
Conclusions
There was no significant association between preterm labor and atherosclerotic CVD in general population. A history of preterm labor is not likely to be a risk factor for later CVD in women.

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