Pre-pregnancy cardiovascular risk factors are highly prevalent and are associated with adverse maternal and fetal outcomes, according to a research letter published in the European Journal of Preventive Cardiology. Researchers pooled individual-level data for 18.6 million pregnancies to examine the impact of four pre-pregnancy cardiovascular risk factors (BMI <18.5 kg/m2 or >24.9 kg/m2 , smoking, hypertension, and diabetes) on maternal and neonatal morbidity and mortality. More than 60% of women had at least one pre-pregnancy cardiovascular risk factor (52.50%, 7.30%, 0.30%, and 0.02% had one, two, three, and four, respectively). Women with one or more risk factors had less receipt of prenatal care, higher prevalence of multiparity, and higher prevalence of prior spontaneous or induced pregnancy loss compared with women with no risk factors. Consistent and marked graded associations were seen between greater pre-pregnancy risk factor burden and higher risk of adverse maternal and fetal outcomes (eg, risk ratios of maternal ICU admission: 1.12, 1.86, 4.24, and 5.79 with one, two, three, and four risk factors, respectively, vs zero risk factors). Similar results were seen for preterm birth, low birth weight, and fetal death. “Our data extend prior findings by validating the importance of the pre-pregnancy cardiovascular risk factor profile for risks of several key adverse maternal and offspring outcomes, which are known to influence the risk of subsequent cardiovascular disease,” the authors wrote.
