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Association between delivery of a small‐for‐gestational‐age neonate and long‐term maternal cardiovascular morbidity
Author(s) -
Pariente Gali,
Sheiner Eyal,
Kessous Roy,
Michael Sherf,
ShohamVardi Ilana
Publication year - 2013
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2013.06.008
Subject(s) - medicine , hazard ratio , small for gestational age , odds ratio , risk factor , proportional hazards model , confidence interval , gestational age , heart failure , pediatrics , obstetrics , pregnancy , biology , genetics
Objective To investigate whether delivering a small‐for‐gestational‐age (SGA) newborn is a risk factor for subsequent long‐term maternal cardiovascular morbidity. Methods Data were analyzed from consecutive pregnant women who delivered at Soroka University Medical Center, Beer‐Sheva, Israel, between 1988 and 1999, and were followed‐up retrospectively until 2010. Long‐term cardiovascular morbidity was compared among women with and without SGA neonates. Results During the study period, 47 612 deliveries met the inclusion criteria, and 4411 (9.3%) women delivered an SGA neonate. Delivery of an SGA neonate was a risk factor for long‐term complex cardiovascular events, including congestive heart failure, hypertensive heart and kidney disease, and acute cor pulmonale (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.3–4.4; P = 0.006); and long‐term cardiovascular mortality (OR, 3.4; 95% CI, 1.5–7.6; P = 0.006). Women who delivered an SGA neonate had a significantly higher risk for cardiovascular mortality during the follow‐up period (Kaplan–Meier survival analysis, P = 0.002). Delivery of an SGA neonate remained an independent risk factor for long‐term maternal cardiovascular mortality (Cox multivariable regression: adjusted hazard ratio, 3.5; 95% CI, 1.5–8.2; P = 0.004). Conclusion Delivery of an SGA neonate is an independent risk factor for long‐term cardiovascular morbidity in a follow‐up period of more than 10 years.