Some pregnancy complications are associated with a heightened risk of heart disease in later life, according to an analysis published today.
An umbrella study published in the latest edition of The BMJ shows that miscarriage, pre-eclampsia, gestational diabetes and pre-term birth are among the complications associated with subsequent cardiovascular disease, while other factors linked to fertility, including starting periods early, use of combined oral contraceptives, polycystic ovary syndrome, and early menopause are also point to a link.
However, the UK-based research team from the University of Birmingham and Queen Mary University of London, UK, found a longer length of breastfeeding was associated with a reduced risk of cardiovascular disease.
Kelvin Okoth, from the University of Birmingham, UK, and team searched relevant research databases for published systematic reviews and meta-analyses that investigated links between reproductive factors in women of reproductive age and their subsequent risk of cardiovascular disease.
They included 32 reviews and evaluated multiple risk factors over an average follow-up period of seven to 10 years.
The researchers found that several factors, including early menarche, use of combined oral contraceptives, polycystic ovary syndrome, miscarriage, stillbirth, diabetes during pregnancy, pre-term birth, low birth weight, and early menopause were associated with an up to twofold risk of cardiovascular disease. Pre-eclampsia was associated with a fourfold risk of heart failure.
Family medical history, genetics, weight, high blood pressure and cholesterol levels, and chemical imbalances from use of hormonal contraceptives are among the possible explanations for the association, they say.
No association was found between cardiovascular disease outcomes and current use of progesterone only contraceptives, use of non-oral hormonal contraceptive agents, or fertility treatment.
Although the researchers point to some limitations in the study, including missing data and that reviews were largely based on observational evidence, they say the evidence reported suggests the reproductive profile of women is associated with their future risk of cardiovascular disease.
Okoth K, Singh Chandan J, Marshall T et al. Association between the reproductive health of young women and cardiovascular disease in later life: umbrella review. BMJ 8 October 2020
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