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Study Finds Obesity during Pregnancy is Independent Risk Factor for Long-Term Cardiovascular Morbidity

In a study to be presented on Feb. 7 at 2:45 p.m. CST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting ™, in New Orleans, researchers will report that obesity during pregnancy is an independent risk factor for long-term cardiovascular morbidity, and these complications tend to occur at a younger age. Researchers concluded that obese pregnant patients might benefit from cardiovascular risk screening that could lead to early detection and secondary prevention of cardiovascular morbidity.

Obesity is considered a chronic disease with a dramatic increase in its prevalence worldwide during the last two decades. Close to one-third of women of childbearing age are classified as obese, and an additional 25 percent of women in this age group are classified as overweight. Maternal pre-pregnancy obesity is a significant risk factor for adverse obstetrical and perinatal outcomes.

The objective of this study, titled OBESITY IN PREGNANCY; WHAT’S NEXT? Long-term cardiovascular morbidity in a follow-up period of more than a decade was to investigate whether obesity in pregnancy is an independent risk factor for long-term subsequent maternal cardiovascular morbidity during a follow-up period of more than a decade.

Researchers evaluated data from pregnant women who delivered between 1988 and 1999, and were followed-up retrospectively until 2010. Long-term cardiovascular morbidity was compared among women with and without obesity in pregnancy (defined as maternal pre-pregnancy body mass index of 30 kg/m2 or more). Cardiovascular morbidity was divided into four categories including simple and complex cardiovascular events and invasive and non-invasive cardiac procedures.

During the period of study, 46,688 women who delivered were recruited, and of that number, 1221 were found to suffer from obesity. Ten years later, these patients had higher rates of simple cardiovascular events, non-invasive diagnostic procedures, and total number of cardiovascular-related hospitalizations.

The data recovered not only indicates an association between obesity in pregnancy and future risk for cardiovascular morbidity, but also reveals the effect of obesity in pregnancy on earlier occurrence of cardiovascular morbidity.

Dr. Shimrit Yaniv Salem, Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer sheva, Israel, said, “These results are of major importance to the obstetricians counseling a patient regarding future risk for cardiovascular complications. It is important for secondary prevention, early detection, and specific screening programs for this population. As obstetricians, we should remember to consult our obese patients not only for possible obstetrical issues but also for long-term cardiovascular complications. Pregnancy is a unique window of opportunity which has an important role in promoting life style modifications.”

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A copy of the abstract is available at http://www.smfmnewsroom.org and below.  For interviews please contact Vicki Bendure at Vicki@bendurepr.com 202-374-9259 (cell), or Meghan Blackburn at Meghan@bendurepr.com, 540-687-5099 (office) or 859-492-6303 (cell).

The Society for Maternal-Fetal Medicine (est. 1977) is the premiere membership organization for obstetricians/gynecologists who have additional formal education and training in maternal-fetal medicine.  The society is devoted to reducing high-risk pregnancy complications by sharing expertise through continuing education to its 2,000 members on the latest pregnancy assessment and treatment methods. It also serves as an advocate for improving public policy, and expanding research funding and opportunities for maternal-fetal medicine. The group hosts an annual meeting in which groundbreaking new ideas and research in the area of maternal-fetal medicine are shared and discussed.  For more information visit www.smfm.org.

Abstract 68: OBESITY IN PREGNANCY; WHAT’S NEXT? Long-term cardiovascular morbidity in a follow-up period of more than a decade

Authors: Shimrit Yaniv Salem1, Roy Kessous1, Gali Pariente1, Ilana Shoham Vardi2, Eyal Sheiner1

1Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer sheva, Israel, 2Ben-Gurion University of the Negev, Epidemiology and Health Services Evaluation, Epidemiology, Beer sheva, Israel

Objective: To investigate whether obesity in pregnancy is an independent risk factor for subsequent long-term cardiovascular morbidity during a follow-up period of more than a decade.

Study Design: Data were analyzed from consecutive pregnant women who delivered between 1988 and 1999, and were followed-up retrospectively until 2010. Long-term cardiovascular morbidity was compared among women with and without obesity in pregnancy (defined as maternal pre-pregnancy body mass index (BMI) of 30 kg/m2 or more). Cardiovascular morbidity was divided into four categories including simple and complex cardiovascular events and invasive and non-invasive cardiac procedures. Kaplan-Meier survival curves were used to compare cumulative incidence of cardiovascular hospitalizations. Cox proportional hazards models were used to estimate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for long term cardiovascular hospitalizations.

Results: During the study period 46,688 women met the inclusion criteria; 1221 (2.6%) suffered from obesity during pregnancy. During a follow up period of more than ten years, patients with obesity had higher risk for cardiovascular hospitalizations (Kaplan-Meier survival analysis, P<0.001; Figure). Specifically, obese patients had higher rates of simple cardiovascular events and non-invasive procedures (Table). These complications tended to occur at a younger age (mean 4871±950 days vs. 5060±1140 days from their pregnancy; p=0.001). In a Cox proportional hazards model, adjusted for diabetes mellitus, preeclampsia and maternal age, obesity was independently associated with long-term cardiovascular hospitalizations (adjusted HR 1.33, 95% CI 1.17-1.5).

Conclusion: Obesity during pregnancy is an independent risk factor for long-term cardiovascular morbidity, and these complications tend to occur at a younger age. Obese parturients might benefit from cardiovascular risk screening that could lead to early detection and secondary prevention of cardiovascular morbidity.

Kaplan-Meier hazard function analysis curve for cardiovascular associated hospitalization of patients with and without obesity

Kaplan-Meier hazard function analysis curve for cardiovascular associated hospitalization of patients with and without obesity

Cardiovascular hospitalizations in patients with and without obesity

Cardiovascular hospitalizations in patients with and without obesity

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