Affiliation:
1. Department of Biomedical Sciences, Humanitas University , via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Milan , Italy
2. IRCCS Humanitas Research Hospital , via Manzoni 56, 20089 Rozzano, Milan , Italy
Abstract
Abstract
Background/introduction
There is a need for further studies on the cardiovascular risk of women experiencing pre-eclampsia (PE).
Purpose
To update the literature regarding the association between a history of PE and subsequent cardiovascular diseases, including cardiovascular death, coronary heart diseases, heart failure, and stroke, focusing on the trend in the effect size (ES) estimates over time.
Methods and results
Following PRISMA guidelines, from inception to May 2023, we performed a systematic review of PubMed, MEDLINE, Scopus, and EMBASE. Randomized, cohort, or case-control studies in English were included if fulfiling the following criteria:(i) The association between PE and subsequent cardiovascular disease was adjusted for clinically relevant variables, (ii) the presence of a control group, and (iii) at least 1 year of follow-up. Pooled adjusted ESs and 95% confidence intervals (CIs) were used as effect estimates and calculated with a random-effect model. Twenty-two studies met the inclusion criteria. PE was associated with a higher risk of cardiovascular death (ES 2.08, 95% CI 1.70–2.54, I2 56%, P < 0.00001), coronary artery diseases (ES 2.04, 95% CI 1.76–2.38, I2 87%, P < 0.00001), heart failure (ES 2.47, 95% CI 1.89–3.22, I2 83%, P < 0.00001), and stroke (ES 1.75, 95% CI 1.52–2.02, I2 72%, P < 0.00001) after adjusting for potential confounders. This risk is evident in the first 1-to-3 years of follow-up and remains significant until 39 years of follow-up.
Conclusions
Compared to women who experienced a normal pregnancy, those suffering from PE have about double the risk of lifetime cardiovascular disease.
Publisher
Oxford University Press (OUP)
Subject
Cardiology and Cardiovascular Medicine,Health Policy
Reference49 articles.
1. Pre-eclampsia rates in the United States, 1980–2010: age–period–cohort analysis;Ananth;BMJ,2013
2. The classification and diagnosis of the hypertensive disorders of pregnancy: statement from the International Society for the Study of Hypertension in Pregnancy (ISSHP);Brown;Hypertens Pregnancy,2001
3. ACOG Practice Bulletin No. 202: gestational hypertension and pre-eclampsia;Obstet Gynecol,2019
4. The 2021 International Society for the Study of Hypertension in Pregnancy classification, diagnosis & management recommendations for international practice;Magee,2022
5. Pre-eclampsia and future cardiovascular health: a systematic review and meta-analysis;Wu;Circ Cardiovasc Qual Outcomes,2017