Pregnancy loss is related to body mass index and prediabetes in early adulthood: Findings from Add Health.
Pregnancy loss is related to body mass index and prediabetes in early adulthood: Findings from Add Health.
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DOI：
10.1371/journal.pone.0277320
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发表时间：
2022
期刊：
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
--
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妊娠丢失，包括流产和死胎，每年影响美国（US）15-20%的妊娠。越来越多的证据表明，妊娠失败与以后生活中更大的心血管疾病（CVD）负担有关。然而，很少有研究评估妊娠失败对成年早期（年龄<35岁）CVD危险因素的影响。本研究的目的是检查妊娠丢失与成年早期CVD危险因素（体重指数，血压，高脂血症，糖尿病状态）之间的关联。我们使用国家青少年到成人健康纵向研究（Add Health）第四波（2007-2009）的公共使用数据集进行了横断面分析。我们的样本包括年龄在24-32岁之间的女性，既往妊娠并完成了生物学数据收集（n = 2，968）。妊娠丢失评估为任何流产或死产史;并量化为无、1次或复发性（≥2次）妊娠丢失。采用线性和逻辑回归分析，调整社会人口学因素、产次、孕期健康行为和抑郁症，检测妊娠丢失与每个心血管疾病危险因素之间的关系。我们测试了与种族/民族的相互作用。共有670名妇女报告了流产，其中28%报告了复发性流产。在非西班牙裔黑人女性中，既往流产与BMI升高3.79（kg/mm 2）相关，但与白色女性无关。与所有活产的妇女相比，反复流产的妇女更容易患糖尿病前期（AOR，1.93; 95% CI，1.10-3.37，p<0.05）。研究结果表明，妊娠丢失可能与成年早期更不利的CVD风险状况有关，特别是对于经历反复妊娠丢失的女性。这突出了需要对年轻女性的心血管疾病风险评估与先前的怀孕损失。进一步的研究是必要的，以确定潜在的危险因素，妊娠损失，可能使妇女心血管疾病。
Pregnancy loss, including miscarriage and stillbirth, affects 15–20% of pregnancies in the United States (US) annually. Accumulating evidence suggests that pregnancy loss is associated with a greater cardiovascular disease (CVD) burden later in life. However, few studies have evaluated the impact of pregnancy loss on CVD risk factors in early adulthood (age <35 years). The aim of this study was to examine associations between pregnancy loss and CVD risk factors (body mass index, blood pressure, hyperlipidemia, diabetes status) in early adulthood. We conducted a cross-sectional analysis using the public-use dataset for Wave IV (2007–2009) of the National Longitudinal Study of Adolescent to Adult Health (Add Health). Our sample consisted of women, ages 24–32 years, with a previous pregnancy who completed biological data collection (n = 2,968). Pregnancy loss was assessed as any history of miscarriage or stillbirth; and quantified as none, one, or recurrent (≥2) pregnancy loss. Associations between pregnancy loss and each CVD risk factor were tested using linear and logistic regression adjusting for sociodemographic factors, parity, health behaviors during pregnancy, and depression. We tested for interactions with race/ethnicity. A total of 670 women reported a pregnancy loss, of which 28% reported recurrent pregnancy loss. A prior pregnancy loss was related to a 3.79 (kg/mm2) higher BMI in non-Hispanic Black women, but not white women. Women with recurrent pregnancy loss were more likely to have prediabetes (AOR, 1.93; 95% CI, 1.10–3.37, p<0.05) than women with all live births. Findings suggest that pregnancy loss may be associated with a more adverse CVD risk profile in early adulthood, particularly for women who experience recurrent pregnancy loss. This highlights the need for CVD risk assessment in young women with a prior pregnancy loss. Further research is necessary to identify underlying risk factors of pregnancy loss that may predispose women to CVD.
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