CVD risk factors a preterm birth culprit?

The risk of preterm delivery among pregnant women appears to be elevated in the presence of traditional cardiovascular disease (CVD) risk factors, such as hypertension, diabetes, and increased levels of total cholesterol and low-density lipoprotein (LDL) cholesterol, a study has found.

Researchers looked at 868 mothers who delivered singleton births, among whom 249 delivered late preterm (32–36 weeks) and 162 early preterm (20–31 weeks). All preterm births were spontaneous, except for the nine cases that were medically indicated. The average maternal age at birth ranged from 29.5 years for preterm births to 29.9 years for full term births.

More obese women had preterm births, while more normal weight and overweight women delivered at term. There was a higher prevalence of diabetes and pre-eclampsia among women with preterm births.

On multivariable logistic regression analysis, prenatal maternal CVD risk factors emerged as predictors of preterm birth. Specifically, the likelihood of the outcome was elevated in all categories of hypertension, with the largest magnitude seen in the pre-eclampsia (preterm birth: adjusted OR [aOR], 13.49; late preterm birth: aOR, 10.62; early preterm birth: aOR, 17.98) and the chronic hypertension groups (early preterm birth: aOR, 4.58).

Meanwhile, diabetes (types 1 and 2 and gestational) carried a threefold risk increase (aOR, 3.06). There was a significant and linear dose response observed between total and LDL cholesterol and late and early preterm birth, with increasing cholesterol values associated with higher risk.

Receiver operating characteristic curves using the described risk factors to predict late and early preterm birth yielded C-statistics of 0.601 and 0.686, respectively.

The present data reinforce the clinical importance of integrating obstetric and cardiovascular risk assessment across the healthcare continuum in women, the researchers said.