Preterm delivery and maternal cardiovascular disease future risk: A systematic review and meta-analysis

Wu, P; Gulati, M; Kwok, CS; Wong, CW; Narain, A; O'Brien, S; Chew-Graham, C; Verma, G; Kadam, U; Mamas, M

Abstract

Objectives

We aimed to systematically evaluate and summarise the evidence on the relationship between preterm birth (<37 weeks of gestational age) and maternal cardiovascular diseases future risk.

Design

Systematic review and meta-analysis of literature.

Methods

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 due to cardiovascular or coronary heart disease and stroke. The associations were quantified using random effects meta-analysis.

Results

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% 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 of gestation or were medically indicated.

Conclusion

Preterm delivery is associated with an increase in future maternal adverse cardiovascular outcomes, including a two-fold increase in deaths due to coronary heart disease. These findings support the consideration of preterm delivery in cardiovascular risk assessment in women at the 6-week postpartum visit.

Citation

Wu, P., Gulati, M., Kwok, C., Wong, C., Narain, A., O'Brien, S., Chew-Graham, C., Verma, G., Kadam, U., & Mamas, M. (2018, April). Preterm delivery and maternal cardiovascular disease future risk: A systematic review and meta-analysis. Poster presented at British Maternal & Fetal Medicine Society (BMFMS) 20th Annual Conference 2018, Brighton, UK

• Presentation Conference Type: Poster
• Conference Name: British Maternal & Fetal Medicine Society (BMFMS) 20th Annual Conference 2018
• Start Date: Apr 19, 2018
• End Date: Apr 20, 2018
• Deposit Date: Jun 26, 2023
• Public URL: https://keele-repository.worktribe.com/output/507203
• Publisher URL: https://obgyn.onlinelibrary.wiley.com/doi/10.1111/1471-0528.15191
• Additional Information: Volume 125, Issue S2