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Risk prediction of maternal cardiovascular disease one year after hypertensive pregnancy complications or gestational diabetes mellitus

Item Type:Article
Title:Risk prediction of maternal cardiovascular disease one year after hypertensive pregnancy complications or gestational diabetes mellitus
Creators Name:Moe, K. and Sugulle, M. and Dechend, R. and Staff, A.C.
Abstract:BACKGROUND: Previous preeclampsia, gestational hypertension and gestational diabetes mellitus show a firm epidemiological association to maternal cardiovascular disease risk. Cardiovascular disease risk assessment is recommended in women after these pregnancy complications, but not offered in most countries. We therefore wanted to evaluate the applicability of currently recommended cardiovascular disease risk scores for women one-year postpartum of such pregnancy complications. DESIGN AND METHODS: We tested applicability of three scoring systems, the Atherosclerotic Cardiovascular Disease (ASCVD) score, the Joint British Societies for the Prevention of Cardiovascular Disease (JBS3) score and Framingham 30 year Risk Score-Cardiovascular Disease (FRS-CVD) in 235 women one-year postpartum (controls: 94, gestational hypertension: 35, preeclampsia: 81, gestational diabetes mellitus: 25). Statistical analysis was performed with Mann-Whitney U test for continuous and Fisher's mid-corrected p and Pearson's r for dichotomous variables. A value of p < 0.050 was considered significant. RESULTS: Most women (87.7%) were below 40 years of age, rendering 10-year risk estimations recommended by American and European societies inapplicable. FRS-CVD could be assessed in all women. Significantly fewer could be assessed by the ASCVD (81.5%) and JBS3 (91.6%). All scoring systems showed small, but significant increases in risk scores for one or more of the pregnancy complication groups, but none at the risk magnitude for cardiovascular disease shown in epidemiological studies. CONCLUSION: We demonstrate that ASCVD, JBS3 and FRS-CVD are inadequate in assessing cardiovascular disease risk one-year postpartum. We suggest that pregnancy complications need to be considered separately when evaluating maternal cardiovascular disease risk and need for postpartum follow-up.
Keywords:Cardiovascular Risk Scores, Hypertensive Pregnancy Disorders, Gestational Diabetes Mellitus, Preeclampsia, Postpartum
Source:European Journal of Preventive Cardiology
Publisher:Sage Publications
Page Range:1273-1283
Date:1 August 2020
Official Publication:https://doi.org/10.1177/2047487319879791
PubMed:View item in PubMed

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