Cardiovascular Health Among Pregnant Women, Aged 20 to 44 Years, in the United States
Cardiovascular Health Among Pregnant Women, Aged 20 to 44 Years, in the United States
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DOI：
10.1161/jaha.119.015123
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发表时间：
2020-02-18
影响因子：
5.4
通讯作者：
Lloyd-Jones, Donald M.
中科院分区：
文献类型：
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作者：
Perak, Amanda M.;Ning, Hongyan;Lloyd-Jones, Donald M.
妊娠是一种心脏代谢应激源，因此是解决女性一生心血管健康（CVH）的关键时期。然而，CVH在美国孕妇之间还没有characterized.Methods和结果，我们分析了横截面数据从国家健康和营养检查调查1999年至2014年为1117怀孕和8200非怀孕妇女，年龄在20至44岁。我们使用针对妊娠修改的美国心脏协会定义评估了7个CVH指标;将指标分类为理想、中等或较差;分别将这些类别分配为2分、1分或0分;并将7个指标相加，总分为0至14分。总分12 ~ 14分表示高CVH; 8 ~ 11分表示中度CVH; 0 ~ 7分表示低CVH。我们应用调查权重生成美国人群水平的CVH水平估计值，并使用人口统计学调整的多分类logistic和线性回归比较孕妇和非孕妇。在孕妇中，CVH指标理想水平的患病率（95% CI）为0.1%（0%-0.3%）饮食，27.3%（22.2%-32.3%）体力活动，38.9%总胆固醇（33.7%-44.0%），51.1%体重指数为46.0%-56.2%，吸烟为77.7%（73.3%-82.2%），血压为90.4%（87.5%-93.3%），空腹血糖为91.6%（88.3%-94.9%）。平均总CVH评分为8.3（95% CI，8.0-8.7）/14，高CVH为4.6%（95% CI，0.5%-8.8%），中度CVH为60.6%（95% CI，52.3%-68.9%），低CVH为34.8%（95% CI，26.4%-43.2%）。妊娠女性的CVH水平显著低于非妊娠女性;例如，13.0%（95% CI，11.0%-15.0%）的非妊娠女性具有高CVH（调整后，比较P=0.01）。
Background Pregnancy is a cardiometabolic stressor and thus a critical period to address women's lifetime cardiovascular health (CVH). However, CVH among US pregnant women has not been characterized.Methods and Results We analyzed cross-sectional data from National Health and Nutrition Examination Surveys 1999 to 2014 for 1117 pregnant and 8200 nonpregnant women, aged 20 to 44 years. We assessed 7 CVH metrics using American Heart Association definitions modified for pregnancy; categorized metrics as ideal, intermediate, or poor; assigned these categories 2, 1, or 0 points, respectively; and summed across the 7 metrics for a total score of 0 to 14 points. Total scores 12 to 14 indicated high CVH; 8 to 11, moderate CVH; and 0 to 7, low CVH. We applied survey weights to generate US population-level estimates of CVH levels and compared pregnant and nonpregnant women using demographic-adjusted polytomous logistic and linear regression. Among pregnant women, the prevalences (95% CIs) of ideal levels of CVH metrics were 0.1% (0%-0.3%) for diet, 27.3% (22.2%-32.3%) for physical activity, 38.9% (33.7%-44.0%) for total cholesterol, 51.1% (46.0%-56.2%) for body mass index, 77.7% (73.3%-82.2%) for smoking, 90.4% (87.5%-93.3%) for blood pressure, and 91.6% (88.3%-94.9%) for fasting glucose. The mean total CVH score was 8.3 (95% CI, 8.0-8.7) of 14, with high CVH in 4.6% (95% CI, 0.5%-8.8%), moderate CVH in 60.6% (95% CI, 52.3%-68.9%), and low CVH in 34.8% (95% CI, 26.4%-43.2%). CVH levels were significantly lower among pregnant versus nonpregnant women; for example, 13.0% (95% CI, 11.0%-15.0%) of nonpregnant women had high CVH (adjusted, comparison P=0.01).Conclusions From 1999 to 2014,