title: Association between delivery of a small-for-gestational-age neonate and long-term maternal cardiovascular morbidity.
abstract: 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Gali
authors.initials: G
authors.lastname: Pariente
authors.forename: Eyal
authors.initials: E
authors.lastname: Sheiner
authors.forename: Roy
authors.initials: R
authors.lastname: Kessous
authors.forename: Sherf
authors.initials: S
authors.lastname: Michael
authors.forename: Ilana
authors.initials: I
authors.lastname: Shoham-Vardi
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000453:epidemiology*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007557:Israel / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D007674:Kidney Diseases / Q000453:epidemiology*; D015999:Multivariate Analysis; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology* / Q000503:physiopathology; D016016:Proportional Hazards Models; D011660:Pulmonary Heart Disease / Q000453:epidemiology; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
keywords: Cardiovascular; Maternal mortality; Morbidity; Small for gestational age