Cardiovascular disease family history and risk of pregnancy loss

Ann Epidemiol. 2019 Jun:34:40-44. doi: 10.1016/j.annepidem.2019.04.002. Epub 2019 Apr 11.

Abstract

Purpose: To determine whether family history of cardiovascular disease (CVD) is a risk factor for pregnancy loss, given potential shared etiology, including vascular mechanisms involved in reproduction and placentation.

Methods: In a prospective study, first-degree family histories were self-reported before pregnancy among women with 1-2 previous losses. Women were followed for up to 6 menstrual cycles while attempting pregnancy and through pregnancy. Pregnancies were ascertained by urinary human chorionic gonadotropin and confirmed by ultrasound. Risk ratios and 95% confidence intervals for pregnancy loss were estimated using weighted Poisson regression models with robust standard errors adjusted for covariates including prepregnancy body mass index and sociodemographics.

Results: Of 1228 women enrolled, 742 had a clinically confirmed pregnancy, and of these, 18% experienced a clinical pregnancy loss. Forty six percent of women reported family history of CVD, diabetes, hypertension, or hypercholesterolemia/dyslipidemia. Family history of CVD was not associated with the risk of pregnancy loss overall (1.01; 95% confidence interval: 0.64, 1.59) or among women with 2 previous losses (1.05; 0.51, 2.17). Family history of hypertension was also not associated with pregnancy loss (0.98; 0.65, 1.46).

Conclusions: Family history of CVD is not providing additional information helpful in determining the risk of subsequent pregnancy loss in an at-risk group.

Keywords: Cardiovascular disease; Family history; Hypertension; Pregnancy loss.

Publication types

  • Observational Study
  • Research Support, N.I.H., Intramural

MeSH terms

  • Abortion, Spontaneous / epidemiology*
  • Adolescent
  • Adult
  • Cardiovascular Diseases / complications*
  • Cardiovascular Diseases / epidemiology*
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Female
  • Humans
  • Hypercholesterolemia / complications*
  • Hypercholesterolemia / epidemiology
  • Hypertension / complications*
  • Hypertension / epidemiology
  • Pregnancy
  • Pregnancy Outcome / epidemiology*
  • Prospective Studies
  • Risk Factors
  • Young Adult