Cardiovascular disease risk in women with adverse pregnancy outcomes: a long-term follow-up study

Adverse pregnancy outcomes (APOs) have the potential to reveal future cardiovascular disease (CVD) risks.

A better understanding of long-term CVD risks associated with APOs could facilitate earlier interventions in up to one-third of pregnant women.

For this purpose, we propose to conduct the first comprehensive assessment of APOs and long-term CVD risks in a large cohort with up to 46-years of follow-up.

We will use state of the art epidemiological methods (Cox regression, co-relative designs, additive and multiplicative interaction tests etc.) to analyze national registry data for all 4.7 M pregnancies in 2.5 M women in Sweden during 1973-2017 and all inpatient and outpatient CVD diagnoses and mortality through 2018 in this 4-year collaborative effort.

Our aims are to determine associations between 4 major APOs (preeclampsia, other hypertensive disorders, gestational diabetes, fetal growth restriction) and long-term CVD risks; identify high-risk subgroups of women who are most susceptible to effects of APOs on long-term CVD risks; assess the influence of familial (genetic and/or environmental) factors; and develop an integrated risk model based on 5 major APOs (including preterm delivery).

The proposed research is clinically significant because CVD is the leading cause of death in women and the results will help improve women´s health by guiding early prevention and long-term clinical care.