Early-onset vs late-onset preeclampsia and risk of coronary atherosclerosis later in life: a clinical follow-up study

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Younger women with previous preeclampsia have an increased risk of coronary atherosclerosis. It is unknown if this risk is associated with the time of onset of preeclampsia.

This study aimed to investigate if women with early-onset preeclampsia have a higher risk of coronary atherosclerosis compared with women with late-onset preeclampsia, independent of other perinatal risk factors.

A total of 911 women with previous preeclampsia aged 35 to 55 years participated in a clinical follow-up study, including clinical examination, comprehensive questionnaires, and cardiac computed tomography scan 13 years (range, 0–28) after index pregnancy. Early- and late-onset preeclampsia were defined as gestational age at delivery of <34+0 and ≥34+0 gestational weeks, respectively. The primary outcome of the study was the presence of coronary atherosclerosis on the cardiac computed tomography. A logistic regression analysis was performed to investigate the association between time of onset of preeclampsia, perinatal risk factors, and the primary outcome.

Women with early-onset preeclampsia (N=139) were older (46.2±5.7 vs 44.4±5.5 years; P<.001), more likely to have hypertension (51.1% vs 35.1%; P≤.001), and had a higher body mass index (27.9±6.3 vs 26.9±5.5 kg/m2; P=.051) compared with women with late-onset preeclampsia (N=772) at follow-up. The prevalence of the primary outcome (coronary atherosclerosis) on the cardiac computed tomography among women with early- and late-onset preeclampsia was 28.8% vs 22.2%, respectively (P=.088; adjusted odds ratio, 1.74; 95% confidence interval, 1.01–3.01; P=.045 after adjustment for maternal age at index pregnancy, prepregnancy body mass index, parity, diabetes in pregnancy, smoking in pregnancy, offspring birthweight and sex, and follow-up length).

Women with early-onset preeclampsia had a slightly higher risk of coronary atherosclerosis compared with women with late-onset preeclampsia. However, according to the current evidence, it does not seem indicated to limit screening, diagnostic, and preventive measures for cardiovascular disease only to women with early-onset preeclampsia.
TidsskriftAmerican Journal of Obstetrics and Gynecology MFM
Udgave nummer5
Antal sider11
StatusUdgivet - 2024

Bibliografisk note

Funding Information:
Funding: The CPH-PRECIOUS study is funded by The Danish Heart Foundation, Rigshospitalets Forskningspulje, Skibsreder Per Henriksen, R og Hustrus Fond, Kong Christian den Tiendes Fond, Br\u00F8drene Hartmanns Fond, Hans og Nora Buchards Fond, Arvid Nilssons Fond, Anita og Tage Therkelsens Fond, Fonden til L\u00E6gevidenskabens Fremme, Aase og Ejnar Danielsens Fond, Hjertecentrets Forskningsudvalg (Rigshospitalet), Direkt\u00F8r Kurt B\u00F8nnelycke og Hustru Fru Grethe B\u00F8nnelyckes Fond, L\u00E6geforeningens Forskningsfond, Helsefonden, Torben & Alice Frimodt Fond and Henry og Astrid M\u00F8llers Fond.

Funding Information:
Although not relevant to the study FG discloses honoraria: Advisor (Bayer, Abbott, Boehringer-Ingelheim, Pfizer, Alnylam, Ionis, Pharmacosmos, Amgen), speakers fee (Orion Pharma, Astra-Zeneca). KFK has received research grants from AP M\u00F8ller og hustru Chastine McKinney M\u00F8llers Fond, The John and Birthe Meyer Foundation, Research Council of Rigshopitalet, The University of Copenhagen, The Danish Heart Foundation, The Lundbeck Foundation, The Danish Agency for Science, Technology and Innovation by The Danish Council for Strategic Research, Novo Nordisk Foundation. KFK is on the Speakers Bureau of Canon Medical Systems.

Funding Information:
The authors would like to express their gratitude to all the participants, the Chief Radiographer Kim Madsen, Chief Radiographer from the Department of Radiology at Rigshospitalet, and his team of radiographers and nurses, who provided valuable technical and logistical support. K.M. declares no conflict of interest. The graphical abstract was created with BioRender.com.

Publisher Copyright:
© 2024 The Author(s)

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