BACKGROUND
Individuals with pregnancies complicated by hypertensive disorders of pregnancy are
at increased risk of cardiovascular disease. However, not all who have hypertensive
disorders of pregnancy are at risk, and not all who have uncomplicated pregnancies
are without risk.
OBJECTIVE
This study aimed to determine if use of first-degree family history of cardiovascular
disease or chronic hypertension better identifies individuals who need postpartum
cardiovascular risk screening.
STUDY DESIGN
Participants were included if they had pregnancies complicated by hypertensive disorders
of pregnancy or uncomplicated, term pregnancies. Individuals with a first-degree relative
with chronic hypertension, myocardial infarction, or stroke were deemed to have a
positive family history and were thus included.
RESULTS
Four groups were considered: 302 individuals with hypertensive disorders of pregnancy
who had a positive family history, 218 individuals with hypertensive disorders of
pregnancy with no family history, 39 control individuals with a positive family history,
and 63 control individuals with no family history. Among individuals with hypertensive
disorders of pregnancy, those with a positive family history were more likely to be
diagnosed with chronic hypertension, and to have elevated 30-year lipid, 30-year body
mass index, and lifetime cardiovascular disease risk score (all P<.05). Among individuals with uncomplicated pregnancies, those with a positive family
history were more likely to be diagnosed with chronic hypertension (P<.05) and meet criteria for metabolic syndrome (P<.05).
CONCLUSION
First-degree family history of cardiovascular disease and/or chronic hypertension
can be used to reliably identify individuals without pregnancy complications who should
have postpartum cardiovascular risk screening, and may better determine which individuals
who have a pregnancy complicated by hypertensive disorders of pregnancy would most
benefit from postpartum cardiovascular risk screening.
Key words
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Article info
Publication history
Published online: January 11, 2023
Accepted:
December 22,
2022
Received in revised form:
December 19,
2022
Received:
November 11,
2022
Footnotes
The authors report no conflict of interest.
The Department of Obstetrics and Gynaecology, Queen's University provided funding for costs of data analysis for this study. The Department otherwise had no role in the study design, analysis, or interpretation of the data. The study was also funded by the Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University, through the Paul Titus Fellowship (2017–2018). The Department had no role in the study design, analysis, or interpretation of the data.
This study was presented at the 69th annual meeting of the Society for Reproductive Investigation, Denver, CO, March 15–19, 2022.
Cite this article as: Ackerman-Banks CM, Pudwell J, Lundsberg L, et al. Use of family history of cardiovascular disease or chronic hypertension to better identify who needs postpartum cardiovascular risk screening. Am J Obstet Gynecol MFM 2023;XX:x.ex–x.ex.
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