Primary atherothrombotic occlusive vascular events in premenopausal women with history of adverse pregnancy outcome.
OBJECTIVE
To determine if adverse pregnancy outcomes are associated with atherothrombotic occlusive vascular disease (AOVD) in premenopausal women.


METHODS
Retrospective matched case-control study.


METHODS
Tertiary, university-affiliated medical center.


METHODS
Women aged less than 50 years treated for an AOVD (primary cerebrovascular, myocardial, or peripheral arterial ischemic event) from 1995 to 2004.


METHODS
The files were reviewed for classical risk factors for AOVD and complications of pregnancy (abortions, pregnancy-induced hypertension, preeclampsia, gestational diabetes, intrauterine growth restriction (IUGR), fetal loss and preterm delivery). Findings were compared with healthy women matched for age and body mass index.


METHODS
Past pregnancy complications in premenopausal women with AOVD.


RESULTS
Of the 101 women with AOVD, 53 had a myocardial ischemic event, 33 a cerebrovascular event, and 15 a peripheral ischemic arterial event. On multivariate analysis, IUGR (OR 8.41, 95% CI 2.36-29.9, p=0.001) and more than one pregnancy complication (OR 13.7, 95% CI 1.56-120, p=0.02) were found to be independent significant variables associated with AOVD.


CONCLUSIONS
IUGR and composite pregnancy complications are independent significant variables associated with AOVD in premenopausal period. Pregnancy outcome might serve as a means to identify patients who may require increased medical surveillance and preventive measures for later vascular disease.
Ben-Ami
S
S
Perinatal Division, The Helen Schneider Hospital for Women, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel.
Oron
G
G
Ben-Haroush
A
A
Blickstein
D
D
Hod
M
M
Bar
J
J
D000328:Adult; D050197:Atherosclerosis / Q000150:complications*; D016022:Case-Control Studies; D016640:Diabetes, Gestational / Q000209:etiology; D005260:Female; D005317:Fetal Growth Retardation / Q000209:etiology; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000209:etiology; D008499:Medical Records; D008875:Middle Aged; D011225:Pre-Eclampsia / Q000209:etiology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D011256:Pregnancy Outcome; D017697:Premenopause; D012189:Retrospective Studies; D012307:Risk Factors; D013927:Thrombosis / Q000150:complications*