Association between aspirin use during pregnancy and cardiovascular risk factors 2-7 years after delivery: The nuMoM2b Heart Health Study.
Association between aspirin use during pregnancy and cardiovascular risk factors 2-7 years after delivery: The nuMoM2b Heart Health Study.
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DOI：
10.1016/j.preghy.2022.01.012
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发表时间：
2022-06
影响因子：
2.2
通讯作者：
Silver, Robert M.
中科院分区：
文献类型：
--
作者：
Theilen, Lauren H.;Greenland, Philip;Varagic, Jasmina;Catov, Janet;Shanks, Anthony;Thorsten, Vanessa;Parker, Corette B.;McNeil, Rebecca;Mercer, Brian;Hoffman, Matthew;Wapner, Ronald;Haas, David;Simhan, Hyagriv;Grobman, William;Chung, Judith H.;Levine, Lisa D.;Barnes, Shannon;Merz, Noel Bairey;Saade, George;Silver, Robert M.
关键词：
评估首次妊娠期间使用阿司匹林与以后母体心血管风险之间的关系。在这项前瞻性队列的二次分析中，我们纳入了首次怀孕20周以上的参与者，他们有阿司匹林使用的数据，并在分娩后2-7年参加了研究访视。暴露是在第一次怀孕期间使用阿司匹林。我们通过logistic回归模型计算阿司匹林使用倾向评分，包括与妊娠期阿司匹林使用和心血管风险相关的基线变量。关注的结果是分娩后2-7年的心血管相关诊断事件。稳健泊松回归计算阿司匹林暴露的结局风险，调整阿司匹林使用倾向评分。主要结局是研究访视时心血管事件诊断的复合终点：心血管事件、慢性高血压、代谢综合征、前驱糖尿病或2型糖尿病、血脂异常和慢性肾脏疾病。在纳入的4，480名妇女中，84名（1.9%）报告在首次怀孕期间服用阿司匹林。阿司匹林暴露组中52.6%的参与者和未暴露组中43.0%的参与者有主要结局。调整阿司匹林使用倾向评分后，首次妊娠期间使用阿司匹林与任何结局均无关。我们没有发现第一次怀孕期间使用阿司匹林与2-7年后心血管相关诊断之间的关联。我们的研究只能检测相对风险的较大差异，因此我们不能排除可能具有临床意义的较小差异。
To evaluate the association between aspirin use during first pregnancy and later maternal cardiovascular risk. In this secondary analysis of a prospective cohort, we included participants who carried their first pregnancy to 20+ weeks, had data regarding aspirin use, and attended a study visit 2-7 years following delivery. The exposure was aspirin use during the first pregnancy. We calculated aspirin use propensity scores from logistic regression models including baseline variables associated with aspirin use in pregnancy and cardiovascular risk. Outcomes of interest were incident cardiovascular-related diagnoses 2-7 years following delivery. Robust Poisson regression calculated the risk of outcomes by aspirin exposure, adjusting for the aspirin use propensity score. The primary outcome was a composite of incident cardiovascular diagnoses at the time of the study visit: cardiovascular events, chronic hypertension, metabolic syndrome, prediabetes or type 2 diabetes, dyslipidemia, and chronic kidney disease. Of 4,480 women included, 84 (1.9%) reported taking aspirin during their first pregnancy. 52.6% of participants in the aspirin-exposed group and 43.0% in the unexposed group had the primary outcome. After adjusting for the aspirin use propensity scores, aspirin use during the first pregnancy was not associated with any of the outcomes. We did not detect an association between aspirin use during the first pregnancy and cardiovascular-related diagnoses 2-7 years later. Our study was only powered to detect a large difference in relative risk, so we cannot rule out a smaller difference that may be clinically meaningful.
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