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The effect of adverse pregnancy outcomes on vascular aging in young women: the Kailuan study

Abstract

Adverse pregnancy outcomes (APOs) are at increased future cardiovascular risk and require effective risk mitigation. However, data regarding appropriate postpartum screening for young women with APOs are lacking. We aimed to investigate the association between APOs and vascular aging by the determination of high pulse wave velocity (PWV) in young women. Women who gave birth from 1990 to 2020 and underwent brachial-ankle pulse wave velocity (baPWV) assessments in the postpartum period were recruited. We excluded women with age ≥50 years at the baPWV assessment or missing postpartum health examinations. The history of APOs including hypertensive disorders of pregnancy, gestational diabetes, preterm delivery, and low birth weight were assessed by medical records. High PWV was defined as baPWV above the 90th percentile for different age group. Multivariable Logistic regression was used to evaluate the association of APOs and high PWV. 3193 participants were included in the analysis, including 912 (28.6%) individuals with APOs. The prevalence of high PWV in the non-APO group and the APOs group were 7.19% (164) and 13.9% (127), respectively (P < 0.05). Compared with non-APO group, the OR (95% CI) of APOs group was 1.67 (1.29–2.16). The risks in the 20–29, 30–39, and 40–49 age groups were 2.51 (1.13–5.59), 1.83 (1.30–2.59), and 1.35 (0.82–2.21) (P for trend <0.05). We conclude that APOs are risk factors of vascular aging for young women and the risk decreased with increasing age. BaPWV should be an important indicator for preventive cardiovascular risk management in young women with APOs. Clinical trial registration: Registration number ChiCTR-TNRC-11001489, http://www.chictr.org.cn/showproj.aspx?proj=8050.

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Fig. 1: Flowchart for the reference population.
Fig. 2: Flowchart for the study population.

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De-identified data are available to researchers upon request by contacting with the corresponding author.

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Acknowledgements

We thank all the survey teams of the Kailuan study group for their contribution and the study participants who contributed their information. All authors revised and approved the article as submitted.

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YLiu, LL, SW and YLi designed this research. YLiu, LL conducted research. SC and GWg provided and monitored databases. YLiu, BT and XD performed statistical analysis. SW and YLiu wrote the manuscript. JS, ZH, JY, NYg, SW and YLi made critical revision to the manuscript. SW and YL had primary responsibility for final content. All authors have read and approved the final manuscript.

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Correspondence to Shouling Wu or Yuming Li.

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This study complied with the Declaration of Helsinki and was approved by the Ethics Committee of Kailuan General Hospital.

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Liu, Y., Lin, L., Tao, B. et al. The effect of adverse pregnancy outcomes on vascular aging in young women: the Kailuan study. J Hum Hypertens 37, 969–976 (2023). https://doi.org/10.1038/s41371-023-00805-1

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