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Spontaneous pre-term delivery linked to increased CVD risk

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Women with a pregnancy history of spontaneous pre-term delivery are at higher risk of cardiovascular diseases later in life, according to a study involving five countries in Northern Europe.

A history of spontaneous preterm delivery appears to double a woman’s risk of heart disease, stroke and other cardiovascular diseases, according to a study published in the European Journal of Preventive Cardiology.

The strength of the association was described by the investigators as “robust”, and, as an independent risk factor for CVD, which was “almost equally strong” as hypertension, high cholesterol, being overweight, smoking and diabetes.

The study was a meta-analysis of 10 existing population studies involving patients from Denmark, Finland, Norway, Scotland and Sweden.

Data analysis showed that spontaneous pre-term delivery was associated with statistically significant increased risks in all parameters measured.

“Spontaneous preterm delivery is an independent risk factor for the development of IHD, stroke and overall CVD”

Study authors

The risk of fatal and non-fatal ischaemic heart disease increased by 38%, the risk of fatal and non-fatal stroke increased by 71%, and the risk of overall fatal and non-fatal CVD more than doubled.

Researchers said the increased risks for women with a history of spontaneous pre-term delivery were “observed consistently” when compared with those in women with term delivery.

Pre-term delivery – defined as delivery before 37 weeks – has been found to occur in 5-11% of pregnancies in Europe.

Around a third are medically indicated, often because of pre-eclampsia and foetal growth restrictions. The cause of the remainder is often unknown but maybe the result of infection, uterine over-distension or uterine anomalies.

Study author Dr Karst Heida, from the University Medical Center in Utrecht in the Netherlands, said there was insufficient evidence at present to include spontaneous pre-term delivery in the accepted cardiovascular risk charts or prevention guidelines.

However, he said a history of spontaneous pre-term delivery may identify women who are at an increased risk of CVD and they “should be encouraged to optimise modifiable risk factors to reduce their risk of future CVD”.

He suggested spontaneous pre-term delivery may act like a “stress-test”, revealing latent chronic disease risk.

“The pathways leading to the increased risk of developing CVD are not clear and there may be overlap with the different pregnancy complications,” he added.

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