Association between infant birth weight, preterm delivery and maternal cardiovascular risk in the Health, Aging and Body Composition Study

Mothers who deliver a low birth weight infant may themselves be at excess risk for cardiovascular disease. We validated maternal recall of infant birth weight after an average follow up of 57 years, and investigated whether older women who reported having delivered low birth weight (LBW) infants (<2500 g) had later elevations in cardiovascular risk factors and were at increased risk for clinical cardiovascular disease. Participants were 446 women (mean age 80 years; 47% black) enrolled in The Health, Aging and Body Composition Study. Women reported birth weight and selected complications for each pregnancy, and pregnancies complicated by hypertension or preeclampsia were excluded. We found strong correlation between recalled and documented birth weights for first births (ICC=0.96) in a randomly selected group of participants, and reliability of recall for first births remained high when considered separately by race, education, income and age. Women who had reported a LBW first birth had a lower current BMI (adjusted for race and age) compared to women with normal weight infants (26.6 vs. 28.0 kg/m²; p=0.057), but they had a higher abdominal circumference (98.1 vs. 95.0 cm; p=0.007). After adjustment for BMI, race and age, women with a history of a LBW vs. normal weight infant had elevated systolic blood pressures (p=0.048) despite higher use of anti-hypertensive medication (p=0.061). Women with LBW infants also had higher levels of IL-6 (p=0.021), fasting insulin (p=0.064), and triglycerides (p=0.071), and they were more insulin resistant (p=0.045) compared to women with a normal weight infant. Women who delivered preterm infants had an elevated risk for cardiovascular disease at age 80 (adjusted odds ratio=2.77, 95% CI 1.06-7.24) compared to women who delivered term infants. Women who had delivered infants both LBW and preterm had markedly elevated cardiovascular risk factors when compared to women with normal weight term infants, and appeared to have the highest risk for clinical cardiovascular disease (adjusted odds ratio=4.21, 95% CI 1.23-14.45). The public health importance of these findings is that a history of LBW or preterm delivery may identify women who would benefit from screening and intervention aimed at risk factors for cardiovascular disease

Re: Moderately elevated blood pressure during pregnancy and odds of hypertension later in life: The POUCHmoms longitudinal study Potential mechanism for pregnant and nonpregnant hypertension

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141906/1/bjo14921.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141906/2/bjo14921_am.pd

Re: Moderately elevated blood pressure during pregnancy and odds of hypertension later in life: The POUCHmoms longitudinal study Potential mechanism for pregnant and nonpregnant hypertension

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141906/1/bjo14921.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141906/2/bjo14921_am.pd

Moderately elevated blood pressure during pregnancy and odds of hypertension later in life: the POUCHmoms longitudinal study

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138364/1/bjo14556-sup-0010-ICMJE7.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138364/2/bjo14556-sup-0007-ICMJE4.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138364/3/bjo14556.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138364/4/bjo14556-sup-0008-ICMJE5.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138364/5/bjo14556-sup-0001-TableS1.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138364/6/bjo14556-sup-0002-TableS2.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138364/7/bjo14556-sup-0005-ICMJE2.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138364/8/bjo14556-sup-0003-TableS3.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138364/9/bjo14556-sup-0006-ICMJE3.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138364/10/bjo14556-sup-0009-ICMJE6.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138364/11/bjo14556_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138364/12/bjo14556-sup-0004-ICMJE1.pd

Maternal hypertension after a low-birth-weight delivery differs by race/ethnicity: Evidence from the National Health and Nutrition Examination Survey (NHANES) 1999-2006

Studies have suggested an increase in maternal morbidity and mortality due to cardiovascular diseases in women with a prior low-birth-weight (LBW, <2,500 grams) delivery. This study evaluated blood pressure and hypertension in women who reported a prior preterm or small-for-gestational-age (SGA) LBW delivery in the National Health and Nutrition Examination Survey 1999-2006 (n = 6,307). This study also aimed to explore if race/ethnicity, menopause status, and years since last pregnancy modified the above associations. A total of 3,239 white, 1,350 black, and 1,718 Hispanics were assessed. Linear regression models were used to evaluate blood pressure by birth characteristics (preterm-LBW, SGA-LBW, and birthweight ≥2,500). Logistic regression models estimated the odds ratios (OR) of hypertension among women who reported a preterm-LBW or SGA-LBW delivery compared with women who reported an infant with birthweight ≥2,500 at delivery. Overall, there was a positive association between a preterm-LBW delivery and hypertension (adjusted OR = 1.39, 95% confidence interval (CI) 1.02-1.90). Prior SGA-LBW also increased the odds of hypertension, but the estimate did not reach statistical significance (adjusted OR = 1.21, 95% CI 0.76-1.92). Race/ethnicity modified the above associations. Only black women had increased risk of hypertension following SGA-LBW delivery (adjusted OR = 2.09, 95% CI 1.12-3.90). Black women were at marginally increased risk of hypertension after delivery of a preterm-LBW (adjusted OR = 1.49, 95% CI 0.93-2.38). Whites and Hispanics had increased, but not statistically significant, risk of hypertension after a preterm-LBW (whites: adjusted OR = 1.39, 95% CI 0.92-2.10; Hispanics: adjusted OR = 1.22, 95% CI 0.62-2.38). Stratified analysis indicated that the associations were stronger among women who were premenopausal and whose last pregnancy were more recent. The current study suggests that in a representative United States population, women with a history of preterm- or SGA-LBW deliveries have increased odds of hypertension and this risk appears to be higher for black women and younger women. © 2014 Xu et al

Birth data accessibility via primary care health records to classify health status in a multi-ethnic population of children: an observational study

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Cardiovascular biochemical risk factors among women with spontaneous preterm delivery

ObjectiveTo determine whether women delivering preterm have unfavorable cardiovascular profiles as compared with women who deliver at term. MethodsA prospective observational cohort study enrolled 165 women with spontaneous preterm delivery (sPTD) at 24(+0) and 36(+6) gestational weeks in three perinatal care centers in The Netherlands between August 2012 and August 2014. Total cholesterol, triglycerides, high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol, apolipoprotein, glucose, and homocysteine were measured within 24hours after delivery. Lipids and cardiovascular biochemical risk factors were compared between women with sPTD and an external comparison group of 30 women with term delivery via analysis of covariance. ResultsMean gestational age at delivery was 30.73.6weeks in the sPTD group and 40.31.3weeks in the reference group. Data were adjusted for body mass index, age, and center. As compared with the reference group, total cholesterol and LDL-cholesterol levels were lower and glucose levels were higher among women with sPTD. ConclusionAn association between sPTD and unfavorable lipids and cardiovascular biochemical risk factors was not established. The higher levels of glucose in the sPTD group might be due to increased insulin resistance, which is associated with a higher risk of sPTD

Effect of oleic acid supplementation on prostaglandin production in maternal endometrial and fetal allantochorion cells isolated from late gestation ewes

Elevated circulating non-esterified fatty acids including oleic acid (OA) are associated with many pregnancy related complications. Prostaglandins (PGs) play crucial roles during parturition. We investigated the effect of OA supplementation on PG production using an in vitro model of ovine placenta

Accuracy and correlates of maternal recall of birthweight and gestational age

OBJECTIVE: To determine the accuracy of maternal recall of children birthweight (BW) and gestational age (GA), using the Danish Medical Birth Register (DBR) as reference and to examine the reliability of recalled BW and its potential correlates. DESIGN: Comparison of data from the DBR and the European Youth Heart Study (EYHS). SETTING: Schools in Odense, Denmark. POPULATION: A total of 1271 and 678 mothers of school children participated with information in the accuracy studies of BW and GA, respectively. The reliability sample of BW was composed of 359 women. METHOD: The agreement between the two sources was evaluated by mean differences (MD), intraclass correlation coefficient (ICC) and Bland-Altman's plots. The misclassification of the various BW and GA categories were also estimated. MAIN OUTCOME MEASURES: Differences between recalled and registered BW and GA. RESULTS: There was high agreement between recalled and registered BW (MD =-0.2 g; ICC = 0.94) and GA (MD = 0.3 weeks; ICC = 0.76). Only 1.6% of BW would have been misclassified into low, normal or high BW and 16.5% of GA would have been misclassified into preterm, term or post-term based on maternal recall. The logistic regression revealed that the most important variables in the discordance between recalled and registered BW were ethnicity and parity. Maternal recall of BW was highly reliable (MD =-5.5 g; ICC = 0.93), and reliability remained high across subgroups. CONCLUSION: Maternal recall of BW and GA seems to be sufficiently accurate for clinical and epidemiological use

History of Adverse Pregnancy Outcomes, Blood Pressure, and Subclinical Vascular Measures in Late Midlife: SWAN (Study of Women’s Health Across the Nation)

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