1
|
Theilen LH, McNeil RB, Hunter S, Grobman WA, Parker CB, Catov JM, Pemberton VL, Ehrenthal DB, Haas DM, Hoffman MK, Chung JH, Mukhtar F, Arzumanyan Z, Mercer B, Parry S, Saade GR, Simhan HN, Wapner RJ, Silver RM. Serum Cotinine and Adverse Cardiovascular Outcomes: A Cross-sectional Secondary Analysis of the nuMoM2b Heart Health Study. Am J Perinatol 2023; 40:1311-1320. [PMID: 34359079 PMCID: PMC8818058 DOI: 10.1055/a-1580-3155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE We aimed to (1) compare serum cotinine with self-report for ascertaining smoking status among reproductive-aged women; (2) estimate the relative odds of adverse cardiovascular (CV) outcomes among women by smoking status; (3) assess whether the association between adverse pregnancy outcomes (APOs) and CV outcomes varies by smoking status. STUDY DESIGN We conducted a cross-sectional study of the nuMoM2b Heart Health Study. Women attended a study visit 2 to 7 years after their first pregnancy. The exposure was smoking status, determined by self-report and by serum cotinine. Outcomes included incident chronic hypertension (HTN), metabolic syndrome (MetS), and dyslipidemia. Multivariable logistic regression estimated odds ratios (ORs) for each outcome by smoking status. RESULTS Of 4,392 women with serum cotinine measured, 3,610 were categorized as nonsmokers, 62 as secondhand smoke exposure, and 720 as smokers. Of 3,144 women who denied tobacco smoke exposure, serum cotinine was consistent with secondhand smoke exposure in 48 (1.5%) and current smoking in 131 (4.2%) After adjustment for APOs, smoking defined by serum cotinine was associated with MetS (adjusted OR [aOR] = 1.52, 95% confidence interval [CI]: 1.21, 1.91) and dyslipidemia (aOR = 1.28, 95% CI: 1.01, 1.62). When stratified by nicotine exposure, nonsmokers with an APO in their index pregnancy had higher odds of stage 1 (aOR = 1.64, 95% CI: 1.32, 2.03) and stage 2 HTN (aOR = 2.92, 95% CI: 2.17, 3.93), MetS (aOR = 1.76, 95% CI: 1.42, 2.18), and dyslipidemia (aOR = 1.55, 95% CI: 1.25, 1.91) relative to women with no APO. Results were similar when smoking exposure was defined by self-report. CONCLUSION Whether determined by serum cotinine or self-report, smoking is associated with subsequent CV outcomes in reproductive-aged women. APOs are also independently associated with CV outcomes in women. KEY POINTS · Cotinine was detected in 5.7% of reported nonsmokers.. · Smoking and APOs were independently associated with CV health.. · Smoking was associated with MetS and dyslipidemia..
Collapse
Affiliation(s)
- Lauren H. Theilen
- Department of Obstetrics and Gynecology, School of Medicine, University of Utah, Salt Lake City, Utah
| | - Rebecca B. McNeil
- Division of Biostatistics and Epidemiology, RTI International, Research Triangle Park, North Carolina
| | - Shannon Hunter
- Division of Biostatistics, RTI International, Research Triangle Park, North Carolina
| | - William A. Grobman
- Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois
| | - Corette B. Parker
- Division of Biostatistics, RTI International, Research Triangle Park, North Carolina
| | - Janet M. Catov
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburg, Pittsburg, Pennsylvania
| | - Victoria L. Pemberton
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute (NHLB), Bethesda, Maryland
| | - Deborah B. Ehrenthal
- Department of Obstetrics and Gynecology, School of Medicine, University of Wisconsin, Madison, Wisconsin
| | - David M. Haas
- Department of Obstetrics and Gynecology, School of Medicine, Indiana University, Indianapolis, Indiana
| | - Matthew K. Hoffman
- Department of Obstetrics and Gynecology, Christiana Care, Wilmington, Delaware
| | - Judith H. Chung
- Department of Obstetrics and Gynecology, School of Medicine, University of California-Irvine, Irvine, California
| | - Farhana Mukhtar
- Department of Obstetrics and Gynecology, School of Medicine, University of California-Irvine, Irvine, California
| | - Zorayr Arzumanyan
- Department of Biomedical Research, The Lundquist Institute, Los Angeles, California
| | - Brian Mercer
- Department of Obstetrics and Gynecology, Case Western Reserve University, Cleveland, Ohio
| | - Samuel Parry
- Department of Maternal Fetal Medicine, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - George R. Saade
- Division Chief of Maternal Fetal Medicine and Ultrasound, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
| | - Hyagriv N. Simhan
- Department of Obstetrics, Gynecology, and Reproductive Science, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Ronald J. Wapner
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York
| | - Robert M. Silver
- Department of Obstetrics and Gynecology, School of Medicine, University of Utah, Salt Lake City, Utah
| |
Collapse
|
2
|
Giorgione V, Jansen G, Kitt J, Ghossein-Doha C, Leeson P, Thilaganathan B. Peripartum and Long-Term Maternal Cardiovascular Health After Preeclampsia. Hypertension 2023; 80:231-241. [PMID: 35904012 DOI: 10.1161/hypertensionaha.122.18730] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
There is widespread acceptance of the increased prevalence of cardiovascular diseases occurring within 1 to 2 decades in women following a preeclamptic pregnancy. More recent evidence suggests that the deranged biochemical and echocardiographic findings in women do not resolve in the majority of preeclamptic women following giving birth. Many women continue to be hypertensive in the immediate postnatal period with some exhibiting occult signs of cardiac dysfunction. There is now promising evidence that with close monitoring and effective control of blood pressure control in the immediate postnatal period, women may have persistently lower blood pressures many years after stopping their medication. This review highlights the evidence that delivering effective medical care in the fourth trimester of pregnancy can improve the long-term cardiovascular health after a preeclamptic birth.
Collapse
Affiliation(s)
- Veronica Giorgione
- Molecular and Clinical Sciences Research Institute, St. George's University of London, London, United Kingdom (V.G., B.T.)
- Fetal Medicine Unit, Department of Obstetrics and Gynaecology, St George's University Hospitals NHS Foundation Trust, London, United Kingdom (V.G., B.T.)
| | - Gwyneth Jansen
- GROW School for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands (G.J., C.G.-D.)
- Department of Cardiology, Zuyderland Medical Centre, Heerlen, the Netherlands (G.J.)
| | - Jamie Kitt
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford' United Kingdom (J.K., P.L.)
| | - Chahinda Ghossein-Doha
- GROW School for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands (G.J., C.G.-D.)
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht' the Netherlands (C.G.-D.)
| | - Paul Leeson
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford' United Kingdom (J.K., P.L.)
| | - Basky Thilaganathan
- Molecular and Clinical Sciences Research Institute, St. George's University of London, London, United Kingdom (V.G., B.T.)
- Fetal Medicine Unit, Department of Obstetrics and Gynaecology, St George's University Hospitals NHS Foundation Trust, London, United Kingdom (V.G., B.T.)
| |
Collapse
|
3
|
Xu J, Li T, Wang Y, Xue L, Miao Z, Long W, Xie K, Hu C, Ding H. The Association Between Hypertensive Disorders in Pregnancy and the Risk of Developing Chronic Hypertension. Front Cardiovasc Med 2022; 9:897771. [PMID: 35872915 PMCID: PMC9301072 DOI: 10.3389/fcvm.2022.897771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveThis meta-analysis comprehensively evaluated the association between hypertensive disorders in pregnancy (HDP) and the risk of developing chronic hypertension and the associations between specific types of HDP, including preeclampsia (PE) and gestational hypertension (GH), and the risk of developing chronic hypertension.DesignSystematic review and meta-analysis.Data SourcesThe PubMed, Embase and Cochrane Library databases were searched from inception to August 20, 2021.MethodsDepending on heterogeneity, the combined odds ratio (OR) of the 95% confidence interval (CI) was obtained with a random-effects or fixed-effects model. We used meta-regression analysis to explore the sources of heterogeneity. We analyzed the OR value after adjusting for age and BMI at recruitment, prepregnancy BMI, age at first delivery, and other factors. Additionally, we evaluated the results of the subgroup analysis by the year of publication (< 2016, ≥ 2016), study design, sample size (< 500, ≥ 500), region (North and South America, Europe, and other regions) and NOS score (< 7, ≥ 7).ResultsOur systematic review and meta-analysis comprehensively explored the relationships between HDP, GH, and PE and chronic hypertension. Twenty-one articles that included 634,293 patients were included. The results of this systematic review and meta-analysis suggested that women with a history of HDP are almost 3.6 times more likely to develop chronic hypertension than those without a history of HDP, women with a history of GH are almost 6.2 times more likely to develop chronic hypertension than those without a history of GH, and women with a history of PE are almost 3.2 times more likely to develop chronic hypertension than those without a history of PE. In addition, we further calculated the probability of developing chronic hypertension among patients with HDP or PE after adjusting for age and BMI at recruitment, prepregnancy BMI, age at first delivery, and other factors. The results suggested that women with a history of HDP are almost 2.47 times more likely to develop chronic hypertension than those without a history of HDP and that women with a history of PE are almost 3.78 times more likely to develop chronic hypertension than those without a history of PE. People in Asian countries are more likely to develop chronic hypertension after HDP or PE, while American people are not at high relative risk.ConclusionThese findings suggest that HDP, GH, and PE increase the likelihood of developing chronic hypertension. After adjustment for age and BMI at recruitment, prepregnancy BMI, age at first delivery, and other factors, patients with HDP or PE were still more likely to develop chronic hypertension. HDP may be a risk factor for chronic hypertension, independent of other risk factors. GH and PE, as types of HDP, may also be risk factors for chronic hypertension.Systematic Review Registration[www.ClinicalTrials.gov], identifier [CRD42021238599].
Collapse
Affiliation(s)
- Jiahao Xu
- Department of Obstetrics and Gynecology, Nanjing Maternity and Child Health Care Hospital, Women’s Hospital of Nanjing Medical University, Nanjing, China
| | - Ting Li
- Department of Obstetrics and Gynecology, Nanjing Maternity and Child Health Care Hospital, Women’s Hospital of Nanjing Medical University, Nanjing, China
| | - Yixiao Wang
- Department of Obstetrics and Gynecology, Nanjing Maternity and Child Health Care Hospital, Women’s Hospital of Nanjing Medical University, Nanjing, China
| | - Lu Xue
- Department of Obstetrics and Gynecology, Nanjing Maternity and Child Health Care Hospital, Women’s Hospital of Nanjing Medical University, Nanjing, China
| | - Zhijing Miao
- Department of Obstetrics and Gynecology, Nanjing Maternity and Child Health Care Hospital, Women’s Hospital of Nanjing Medical University, Nanjing, China
| | - Wei Long
- Department of Obstetrics and Gynecology, Nanjing Maternity and Child Health Care Hospital, Women’s Hospital of Nanjing Medical University, Nanjing, China
| | - Kaipeng Xie
- Department of Public Health, Nanjing Maternity and Child Health Care Hospital, Women’s Hospital of Nanjing Medical University, Nanjing, China
| | - Chen Hu
- Department of Women Health Care, Nanjing Maternity and Child Health Care Hospital, Women’s Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Chen Hu,
| | - Hongjuan Ding
- Department of Obstetrics and Gynecology, Nanjing Maternity and Child Health Care Hospital, Women’s Hospital of Nanjing Medical University, Nanjing, China
- Hongjuan Ding,
| |
Collapse
|
4
|
Theilen LH, Greenland P, Varagic J, Catov J, Shanks A, Thorsten V, Parker CB, McNeil R, Mercer B, Hoffman M, Wapner R, Haas D, Simhan H, Grobman W, Chung JH, Levine LD, Barnes S, Bairey Merz N, Saade G, Silver RM. Association between aspirin use during pregnancy and cardiovascular risk factors 2-7 years after delivery: The nuMoM2b Heart Health Study. Pregnancy Hypertens 2022; 28:28-34. [PMID: 35158155 PMCID: PMC9133043 DOI: 10.1016/j.preghy.2022.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 01/08/2022] [Accepted: 01/31/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To evaluate the association between aspirin use during first pregnancy and later maternal cardiovascular risk. STUDY DESIGN In this secondary analysis of a prospective cohort, we included participants who carried their first pregnancy to 20 + weeks, had data regarding aspirin use, and attended a study visit 2-7 years following delivery. The exposure was aspirin use during the first pregnancy. We calculated aspirin use propensity scores from logistic regression models including baseline variables associated with aspirin use in pregnancy and cardiovascular risk. Outcomes of interest were incident cardiovascular-related diagnoses 2-7 years following delivery. Robust Poisson regression calculated the risk of outcomes by aspirin exposure, adjusting for the aspirin use propensity score. MAIN OUTCOME MEASURES The primary outcome was a composite of incident cardiovascular diagnoses at the time of the study visit: cardiovascular events, chronic hypertension, metabolic syndrome, prediabetes or type 2 diabetes, dyslipidemia, and chronic kidney disease. RESULTS Of 4,480 women included, 84 (1.9%) reported taking aspirin during their first pregnancy. 52.6% of participants in the aspirin-exposed group and 43.0% in the unexposed group had the primary outcome. After adjusting for the aspirin use propensity scores, aspirin use during the first pregnancy was not associated with any of the outcomes. CONCLUSION We did not detect an association between aspirin use during the first pregnancy and cardiovascular-related diagnoses 2-7 years later. Our study was only powered to detect a large difference in relative risk, so we cannot rule out a smaller difference that may be clinically meaningful.
Collapse
Affiliation(s)
- Lauren H Theilen
- University of Utah School of Medicine, 30 N 1900 E, Salt Lake City, UT 84132, United States.
| | - Philip Greenland
- Northwestern University Feinberg School of Medicine, 680 N Lakeshore Dr, Chicago, IL 60611, United States.
| | - Jasmina Varagic
- National Heart, Lung, and Blood Institute, 31 Center Drive, Bethesda, MD 20892, United States.
| | - Janet Catov
- University of Pittsburgh, 300 Halket Street, Pittsburgh, PA 15213, United States.
| | - Anthony Shanks
- Indiana University School of Medicine, 720 Eskenazi Avenue, Indianapolis, IN 46202, United States.
| | | | | | | | - Brian Mercer
- MetroHealth, 2500 MetroHealth Drive, G267, Cleveland, OH 44109, United States.
| | - Matthew Hoffman
- Christiana Care, 4755 Ogletown Stanton Road, Newark, DE 19718, United States.
| | - Ronald Wapner
- Columbia University, 622 West 168(th) Street, New York, NY 10032, United States.
| | - David Haas
- Indiana University School of Medicine, 720 Eskenazi Avenue, Indianapolis, IN 46202, United States.
| | - Hyagriv Simhan
- University of Pittsburgh, 300 Halket Street, Pittsburgh, PA 15213, United States.
| | - William Grobman
- Northwestern University Feinberg School of Medicine, 680 N Lakeshore Dr, Chicago, IL 60611, United States.
| | - Judith H Chung
- University of California, Irvine, 333 City Tower West, Suite 1400, Orange, CA 92868, United States.
| | - Lisa D Levine
- University of Pennsylvania Perelman School of Medicine, 3400 Spruce Street, 2 Silverstein, Philadelphia, PA 19104, United States.
| | - Shannon Barnes
- Indiana University School of Medicine, 720 Eskenazi Avenue, Indianapolis, IN 46202, United States.
| | - Noel Bairey Merz
- Cedars Sinai Smidt Heart Institute, 127 S San Vicente Blvd #A3600, Los Angeles, CA 90048, United States.
| | - George Saade
- University of Texas Medical Branch, 1005 Harborside Drive, Galveston, TX 77555, United States.
| | - Robert M Silver
- University of Utah School of Medicine, 30 N 1900 E, Salt Lake City, UT 84132, United States.
| |
Collapse
|
5
|
Johnston A, Tseung V, Dancey SR, Visintini SM, Coutinho T, Edwards JD. Use of Race, Ethnicity, and National Origin in Studies Assessing Cardiovascular Risk in Women With a History of Hypertensive Disorders of Pregnancy. CJC Open 2021; 3:S102-S117. [PMID: 34993440 PMCID: PMC8712581 DOI: 10.1016/j.cjco.2021.08.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 08/10/2021] [Indexed: 11/06/2022] Open
Abstract
Women with a history of hyperBtensive disorders of pregnancy (HDP) are at particularly high risk for cardiovascular disease (CVD) and CVD-related death, and certain racial and ethnic subpopulations are disproportionately affected by these conditions. We examined the use of race, ethnicity, and national origin in observational studies assessing CVD morbidity and mortality in women with a history of HDP. A total of 124 studies, published between 1976 and 2021, were reviewed. We found that white women were heavily overrepresented, encompassing 53% of all participants with HDP. There was limited and heterogeneous reporting of race and ethnicity information across studies and only 27 studies reported including race and/or ethnicity variables in at least 1 statistical analysis. Only 2 studies mentioned the use of these variables as a strength; several others (k = 18) reported a lack of diversity among participants as a study limitation. Just over half of included articles (k = 68) reported at least 1 sociodemographic variable other than race and ethnicity (eg, marital status and income); however, none investigated how they might have worked synergistically or antagonistically with race and/or ethnicity to influence participants' risk of CVD. These findings highlight significant areas for improvement in cardiovascular obstetrics research, including the need for more robust and standardized methods for collecting, reporting, and using sociodemographic information. Future studies of CVD risk in women with a history of HDP should explicitly examine racial and ethnic differences and use an intersectional approach.
Collapse
Affiliation(s)
- Amy Johnston
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Brain and Heart Nexus Research Program, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Victrine Tseung
- Brain and Heart Nexus Research Program, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Sonia R. Dancey
- School of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Sarah M. Visintini
- Berkman Library, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Thais Coutinho
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- Canadian Women’s Heart Health Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Jodi D. Edwards
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Brain and Heart Nexus Research Program, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- IC/ES, Ottawa, Ontario, Canada
| |
Collapse
|
6
|
Wang MC, Freaney PM, Perak AM, Greenland P, Lloyd-Jones DM, Grobman WA, Khan SS. Trends in Prepregnancy Obesity and Association With Adverse Pregnancy Outcomes in the United States, 2013 to 2018. J Am Heart Assoc 2021; 10:e020717. [PMID: 34431359 PMCID: PMC8649260 DOI: 10.1161/jaha.120.020717] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background The prevalence of obesity in the population has increased in parallel with increasing rates of adverse pregnancy outcomes (APOs). Quantifying contemporary trends in prepregnancy obesity and associations with interrelated APOs (preterm birth, low birth weight, and pregnancy‐associated hypertension) together and individually can inform prevention strategies to optimize cardiometabolic health in women and offspring. Methods and Results We performed a serial, cross‐sectional study using National Center for Health Statistics birth certificate data including women aged 15 to 44 years with live singleton births between 2013 and 2018, stratified by race/ethnicity (non‐Hispanic White, non‐Hispanic Black, Hispanic, and non‐Hispanic Asian). We quantified the annual prevalence of prepregnancy obesity (body mass index ≥30.0 kg/m2; body mass index ≥27.5 kg/m2 if non‐Hispanic Asian). We then estimated adjusted associations using multivariable logistic regression (odds ratios and population attributable fractions) for obesity‐related APOs compared with normal body mass index (18.5–24.9 kg/m2; 18.5–22.9 kg/m2 if non‐Hispanic Asian). Among 20 139 891 women, the prevalence of prepregnancy obesity increased between 2013 and 2018: non‐Hispanic White (21.6%–24.8%), non‐Hispanic Black (32.5%–36.2%), Hispanic (26.0%–30.5%), and non‐Hispanic Asian (15.3%–18.6%) women (P‐trend < 0.001 for all). Adjusted odds ratios (95% CI) for APOs associated with obesity increased between 2013 and 2018, and by 2018, ranged from 1.27 (1.25–1.29) in non‐Hispanic Black to 1.94 (1.92–1.96) in non‐Hispanic White women. Obesity was most strongly associated with pregnancy‐associated hypertension and inconsistently associated with preterm birth and low birth weight. Population attributable fractions of obesity‐related APOs increased over the study period: non‐Hispanic White (10.6%–14.7%), non‐Hispanic Black (3.7%–6.9%), Hispanic (7.0%–10.4%), and non‐Hispanic Asian (7.4%–9.7%) women (P‐trend < 0.01 for all). Conclusions The prevalence of prepregnancy obesity and burden of obesity‐related APOs have increased, driven primarily by pregnancy‐associated hypertension, and vary across racial/ethnic subgroups.
Collapse
Affiliation(s)
- Michael C Wang
- Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL
| | - Priya M Freaney
- Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL.,Division of Cardiology Northwestern University Feinberg School of Medicine Chicago IL
| | - Amanda M Perak
- Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL.,Ann & Robert H. Lurie Children's Hospital of Chicago Chicago IL
| | - Philip Greenland
- Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL.,Division of Cardiology Northwestern University Feinberg School of Medicine Chicago IL
| | - Donald M Lloyd-Jones
- Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL.,Division of Cardiology Northwestern University Feinberg School of Medicine Chicago IL
| | - William A Grobman
- Department of Obstetrics and Gynecology Northwestern University Feinberg School of Medicine Chicago IL
| | - Sadiya S Khan
- Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL.,Division of Cardiology Northwestern University Feinberg School of Medicine Chicago IL
| |
Collapse
|
7
|
Pacheco-Romero J, Acosta O, Huerta D, Cabrera S, Vargas M, Mascaro P, Huamán M, Sandoval J, López R, Mateus J, Gil E, Guevara E, Butrica N, Catari D, Bellido D, Custodio G, Naranjo A. Genetic markers for preeclampsia in Peruvian women. Colomb Med (Cali) 2021; 52:e2014437. [PMID: 33911318 PMCID: PMC8054708 DOI: 10.25100/cm.v52i1.4437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/13/2020] [Accepted: 01/28/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Preeclampsia is a multiorgan disorder associated with maternal and perinatal morbi-mortality. In Peru, incidence is 10% and accounts for 22% of maternal deaths. Genome and genetic epidemiological studies have found an association between preeclampsia and genetic polymorphisms. OBJECTIVE To determine the association of the vascular endothelial growth factor (VEGF) +936 C/T and +405 G/C, interleukine-6 (IL-6) -174 G/C, IL-1β-511 C/T, Apo A-1-75 G/A, Apo B-100 2488 C/T (Xbal) polymorphisms with preeclampsia in pregnant Peruvian women. METHODS Were included preeclamptic and healthy (control) pregnant women. Maternal blood samples were subjected to DNA extraction, and molecular genetic analysis was conducted using the PCR-RFLP technique and following a specific protocol for each gene. Allele and genotypic frequencies in the cases and controls were compared. RESULTS No association was found between the VEGF+936C/T and VEGF+405 polymorphisms and preeclampsia. The frequencies of the GG genotypes and the G allele of the -174 G/C polymorphism in the IL6 gene in preeclamptic and controls showed significant differences, with higher frequencies in cases. For the -511 C/T polymorphism of the IL-1β gene, no significant differences were found in the frequencies of TT genotypes compared with CT+CC. The genotypes and alleles of the Apo-A1-75 G/A and Apo-B100 Xbal variants showed no significant differences between cases and controls. CONCLUSION No association was found between the studied genetic markers and preeclampsia. However, in the -174G/C polymorphism of the IL-6 gene, significant differences were found mainly in the GG genotype and G allele.
Collapse
Affiliation(s)
- José Pacheco-Romero
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
| | - Oscar Acosta
- Universidad Nacional Mayor de San Marcos, Faculty of Pharmacy and Biochemistry, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of Pharmacy and BiochemistryLimaPeru
| | - Doris Huerta
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
| | - Santiago Cabrera
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
| | - Marlene Vargas
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
| | - Pedro Mascaro
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
| | - Moisés Huamán
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
| | - José Sandoval
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
| | - Rudy López
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
| | - Julio Mateus
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
- Atrium Health, Charlotte, North Carolina, USA.Atrium HealthCharlotteNorth CarolinaUSA
| | - Enrique Gil
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
| | - Enrique Guevara
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
| | - Nitza Butrica
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
| | - Diana Catari
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
| | - David Bellido
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
| | - Gina Custodio
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
| | - Andrea Naranjo
- Universidad Nacional Mayor de San Marcos, Faculty of Medicine. Medicina y Genética Molecular Materno Perinatal-MEGEMAPE Research Group, Lima, Peru.Universidad Nacional Mayor de San MarcosUniversidad Nacional Mayor de San MarcosFaculty of MedicineMedicina y Genética Molecular Materno Perinatal-MEGEMAPE Research GroupLimaPeru
| |
Collapse
|
8
|
de Arruda Veiga EC, Rocha PRH, Caviola LL, Cardoso VC, da Silva Costa F, da Conceição Pereira Saraiva M, Barbieri MA, Bettiol H, Cavalli RC. Previous preeclampsia and its association with the future development of cardiovascular diseases: a systematic review and meta-analysis. Clinics (Sao Paulo) 2021; 76:e1999. [PMID: 33503177 PMCID: PMC7798130 DOI: 10.6061/clinics/2021/e1999] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 09/24/2020] [Indexed: 11/18/2022] Open
Abstract
Preeclampsia is a multifactorial disease. Among these factors, untreated hypertension during pregnancy can result in high morbidity and mortality rates and may also be related to the future development of cardiovascular diseases.Therefore, this systematic review aimed to determine the association of previous preeclampsia with the future development of cardiovascular diseases. Studies on the association between preeclampsia and future cardiovascular diseases published in the last 10 years (2009-2019) were identified from the PubMed/Medline (207 articles), Embase (nine articles), and Cochrane (three articles) databases using the keywords "preeclampsia" and "future cardiovascular diseases", "preeclampsia" and "future heart attack", and "preeclampsia" and "future cardiac disease". After applying the inclusion and exclusion criteria, 15 articles were analyzed by systematic review and meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The meta-analysis and the determination of the quality of the articles were conducted using RevMan software, version 5.3. Statistically significant differences were observed between the control and previous preeclampsia groups with respect to systolic blood pressure (mean difference [MD] 4.32; 95% confidence interval [95%CI] 3.65, 4.99; p<0.001), diastolic blood pressure (MD): 2.11; 95%CI: 1.68, 2.55; p<0.0001), and insulin level (MD: 2.80; 95% CI: 0.50, 5.11; p<0.001). Body mass index (MD: 2.57, 95%CI: 2.06, 3.07; p=0.0001), total cholesterol (MD: 10.39; 95%CI: 8.91, 11.87; p=0.0001), HDL (MD: 2.83; 95%CI: 2.20, 3.46; p=0.0001), and LDL (MD: 1.77; 95%CI: 0.42, 3.13; p=0.0001) also differed significantly between groups. Thus, the results of the present study showed that women with a history of preeclampsia were more likely to develop cardiovascular disease.
Collapse
Affiliation(s)
- Eduardo Carvalho de Arruda Veiga
- Departamento de Obstetricia e Ginecologia, Hospital Universitario, Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo (FMRP-USP), SP, BR
| | | | - Leonardo L. Caviola
- Disciplina de Ginecologia, Departamento de Obstetricia e Ginecologia, Hospital Universitario, Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo (FMRP-USP), SP, BR
| | - Viviane Cunha Cardoso
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo (FMRP-USP), SP, BR
| | - Fabricio da Silva Costa
- Departamento de Obstetricia e Ginecologia, Hospital Universitario, Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo (FMRP-USP), SP, BR
| | - Maria da Conceição Pereira Saraiva
- Departamento de Odontologia Pediatrica, Escola de Odontologia de Ribeirao Preto, Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo (FMRP-USP), SP, BR
| | - Marco Antonio Barbieri
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo (FMRP-USP), SP, BR
| | - Heloisa Bettiol
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo (FMRP-USP), SP, BR
| | - Ricardo Carvalho Cavalli
- Departamento de Obstetricia e Ginecologia, Hospital Universitario, Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo (FMRP-USP), SP, BR
| |
Collapse
|
9
|
Varagic J, Desvigne-Nickens P, Gamble-George J, Hollier L, Maric-Bilkan C, Mitchell M, Pemberton VL, Redmond N. Maternal Morbidity and Mortality: Are We Getting to the "Heart" of the Matter? J Womens Health (Larchmt) 2020; 30:178-186. [PMID: 33259740 PMCID: PMC8020498 DOI: 10.1089/jwh.2020.8852] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Cardiovascular disease (CVD), including hypertensive disorders of pregnancy (HDP) and peripartum cardiomyopathy, is a leading cause of pregnancy-related death in the United States. Women who are African American or American Indian/Alaskan Native, have HDP, are medically underserved, are older, or are obese have a major risk for the onset and/or progression of CVD during and after pregnancy. Paradoxically, women with no preexisting chronic conditions or risk factors also experience significant pregnancy-related cardiovascular (CV) complications. The question remains whether substantial physiologic stress on the CV system during pregnancy reflected in hemodynamic, hematological, and metabolic changes uncovers subclinical prepregnancy CVD in these otherwise healthy women. Equally important and similarly understudied is the concept that women's long-term CV health could be detrimentally affected by adverse pregnancy outcomes, such as preeclampsia, gestational hypertension, and diabetes, and preterm birth. Thus, a critical life span perspective in the assessment of women's CV risk factors is needed to help women and health care providers recognize and appreciate not only optimal CV health but also risk factors present before, during, and after pregnancy. In this review article, we highlight new advancements in understanding adverse, pregnancy-related CV conditions and will discuss promising strategies or interventions for their prevention, diagnosis, and treatment.
Collapse
Affiliation(s)
- Jasmina Varagic
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Patrice Desvigne-Nickens
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Joyonna Gamble-George
- Center for Translational Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Lisa Hollier
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA
| | - Christine Maric-Bilkan
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Megan Mitchell
- Division of Extramural Research Activities, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Victoria L Pemberton
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Nicole Redmond
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| |
Collapse
|
10
|
Habibi N, Grieger JA, Bianco-Miotto T. A Review of the Potential Interaction of Selenium and Iodine on Placental and Child Health. Nutrients 2020; 12:nu12092678. [PMID: 32887377 PMCID: PMC7551633 DOI: 10.3390/nu12092678] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/28/2020] [Accepted: 08/28/2020] [Indexed: 12/12/2022] Open
Abstract
A healthy pregnancy is important for the growth and development of a baby. An adverse pregnancy outcome is associated with increased chronic disease risk for the mother and offspring. An optimal diet both before and during pregnancy is essential to support the health of the mother and offspring. A key mediator of the effect of maternal nutrition factors on pregnancy outcomes is the placenta. Complicated pregnancies are characterized by increased oxidative stress in the placenta. Selenium and iodine are micronutrients that are involved in oxidative stress in placental cells. To date, there has been no comprehensive review investigating the potential synergistic effect of iodine and selenium in the placenta and how maternal deficiencies may be associated with increased oxidative stress and hence adverse pregnancy outcomes. We undertook a hypothesis-generating review on selenium and iodine, to look at how they may relate to pregnancy complications through oxidative stress. We propose how they may work together to impact pregnancy and placental health and explore how deficiencies in these micronutrients during pregnancy may impact the future health of offspring.
Collapse
Affiliation(s)
- Nahal Habibi
- School of Agriculture, Food and Wine, Waite Research Institute, and Robinson Research Institute, University of Adelaide, Adelaide 5005, Australia;
| | - Jessica A. Grieger
- Adelaide Medical School, and Robinson Research Institute, University of Adelaide, Adelaide 5005, Australia
- Correspondence: (J.A.G.); (T.B.-M.)
| | - Tina Bianco-Miotto
- School of Agriculture, Food and Wine, Waite Research Institute, and Robinson Research Institute, University of Adelaide, Adelaide 5005, Australia;
- Correspondence: (J.A.G.); (T.B.-M.)
| |
Collapse
|