Association of Spontaneous Preterm Delivery and Future Maternal Cardiovascular Disease.

Margo B Minissian, Sarah Kilpatrick, Jo-Ann Eastwood, Wendie A Robbins, Eynav E Accortt, Janet Wei, Chrisandra L Shufelt, Lynn V Doering, C Noel Bairey Merz

Journal: Circulation 2019;137(8):865-871

PMID: 29459472

Abstract

Cardiovascular disease (CVD) risk factors are well established. However, little is known about a woman's cardiovascular response to pregnancy, which appears to be an early marker of future maternal CVD risk. Spontaneous preterm delivery (sPTD) has been associated with a ≤3-fold increased risk of maternal CVD death later in life compared with having a term delivery. This review focuses on 3 key areas to critically assess the association of sPTD and future maternal CVD risk: (1) CVD risk factors, (2) inflammatory biomarkers of interest, and (3) specific forms of vascular dysfunction, such as endothelial function and arterial stiffness, and mechanisms by which each may be linked to sPTD. The association of sPTD with subsequent future maternal CVD risk suggests that a woman's abnormal response to pregnancy may serve as her first physiological stress test. These findings suggest that future research is needed to understand why women with sPTD may be at risk for CVD to implement effective interventions earlier in a woman's life.

© 2018 American Heart Association, Inc.

Address: Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute (M.B.M., J.W., C.L.S., C.N.B.M.) [email protected].; Brawerman Nursing Institute (M.B.M.).; School of Nursing, University of California, Los Angeles (M.B.M., J.E., W.A.R., L.V.D.).; Department of Obstetrics and Gynecology (S.K., E.E.A.), Cedars-Sinai Medical Center, Los Angeles, CA.; School of Nursing, University of California, Los Angeles (M.B.M., J.E., W.A.R., L.V.D.).; Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute (M.B.M., J.W., C.L.S., C.N.B.M.).
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