title: Preconception cardiovascular risk factors and pregnancy outcome.
abstract: BACKGROUND
  Pregnancy-related cardiovascular conditions are associated with both poorer pregnancy outcomes and cardiovascular disease later in life. Little is known about the relationship between preconception cardiovascular risk factor levels and pregnancy complications.
  
  
  METHODS
  Data from the Cardiovascular Risk in Young Finns Study were linked with birth registry data for 1142 primiparous women. Age-standardized levels of total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, blood pressure, insulin, and glucose from the study visit prior to last menstrual period were calculated. These factors were examined as predictors of gestational age, preterm birth (<37 weeks), birthweight, low birthweight (<2500 g), small-for-gestational-age (weight <10th percentile for gestational age), hypertensive disorders of pregnancy, and gestational diabetes, using linear and Poisson regression with adjustment for age, body mass index, smoking, and socioeconomic status.
  
  
  RESULTS
  Higher triglycerides were associated with a higher risk of hypertensive disorders (adjusted risk ratio [aRR] = 1.42 [95% confidence interval (CI) = 0.90-2.23]), preeclampsia (1.70 [1.08-2.65]), and gestational diabetes (1.68 [1.25-2.25]). After removing women with pregnancy complications (n = 30), the estimated aRR for the association between systolic blood pressure and preterm birth was 1.23 (95% CI = 0.99-1.54); for HDL-c and low birthweight, 0.97 (0.73-1.28); for diastolic blood pressure and small-for-gestational-age, 0.98 (0.81-1.20); and for systolic blood pressure and small-for-gestational-age, 1.18 (0.97-1.45).
  
  
  CONCLUSIONS
  High lipid levels before pregnancy predict an increased risk of preeclampsia and gestational diabetes. Reported associations between these pregnancy complications and later cardiovascular disease of the mother are probably explained, at least in part, by maternal conditions that precede pregnancy. Interventions to improve cardiovascular health before pregnancy may reduce risk of pregnancy complications.
authors.affiliation: Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA, USA. eharvill@tulane.edu
authors.forename: Emily W
authors.initials: EW
authors.lastname: Harville
authors.forename: Jorma S A
authors.initials: JS
authors.lastname: Viikari
authors.forename: Olli T
authors.initials: OT
authors.lastname: Raitakari
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D001794:Blood Pressure; D002784:Cholesterol / Q000097:blood*; D015331:Cohort Studies; D016640:Diabetes, Gestational; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007328:Insulin / Q000097:blood*; D016014:Linear Models; D011225:Pre-Eclampsia; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood*; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D007328:Insulin; D014280:Triglycerides; D002784:Cholesterol