Pregnancy Loss and Carotid Intima–Media Thickness in Mexican Women

Author:

Hartasanchez Sandra A.12,Flores‐Torres Mario2,Monge Adriana23,Yunes Elsa2,Rodriguez Beatriz34,Cantu‐Brito Carlos35,Colaci Daniela6,Lamadrid‐Figueroa Hector2,Lopez‐Ridaura Ruy2,Lajous Martin27

Affiliation:

1. School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico

2. Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico

3. Escuela de Medicina, Instituto Tecnológico de Estudios Superiores de Monterrey, Mexico

4. John A. Burns School of Medicine, University of Hawaii, Honolulu, HI

5. Department of Neurology and Psychiatry, National Institute of Medical Sciences and Nutrition Salvador Zubiran, México City, Mexico

6. Department of Maternal and Child's Health, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina

7. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA

Abstract

Background Cardiovascular disease in women often develops without conventional risk factors. Prenatal loss is a common pregnancy outcome that may result in physiological changes can increase the potential future risk of cardiovascular disease. Insufficient information exists regarding the impact of pregnancy loss on early markers of cardiovascular disease risk. Methods and Results Cross‐sectional analysis of 1767 disease‐free women from the MTC (Mexican Teachers' Cohort) who had been pregnant was used to evaluate the relationship between pregnancy loss and carotid intima–media thickness (IMT). Participants responded to a questionnaire regarding their reproductive history, risk factors, and medical conditions. We defined pregnancy loss as history of miscarriage and/or stillbirth. Trained neurologists measured IMT using ultrasound. We log‐transformed IMT and defined subclinical carotid atherosclerosis (SCA) as IMT ≥0.8 mm and/or plaque. We used multivariable linear and logistic regression models to assess the relation of pregnancy loss, IMT, and SCA. The mean age of participants was 49.8±5.1 years. The prevalence of pregnancy loss was 22%, and we observed SCA in 23% of participants. Comparing participants who reported a pregnancy loss and those who did not, the multivariable‐adjusted odds ratio for SCA was 1.52 (95% confidence interval, 1.12–2.06). Women who experienced a stillbirth had 2.32 higher odds (95% confidence interval, 1.03–5.21) of SCA than those who did not. Mean IMT appeared to be higher in women who reported a pregnancy loss relative to those who did not; nevertheless, this was not statistically significant. Conclusions Pregnancy loss could be linked to cardiovascular disease later in life. The key findings of our study await confirmation and further investigation of the potential underlying mechanisms for this association is required.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

Reference38 articles.

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4. (INEGI) I . Encuesta Nacional de la Dinámica Demográfica 2014. Beta.inegi.org.mx. 2017. Available from: http://www.beta.inegi.org.mx/proyectos/enchogares/especiales/enadid/2014/. Accessed July 10 2017.

5. Stillbirths: Where? When? Why? How to make the data count?

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