UCLA

Background: Although many atherosclerotic cardiovascular disease (ASCVD) risk factors are well established, less is known about a woman’s cardiovascular response to pregnancy, which appears to be an early marker of future maternal CVD risk. Adverse pregnancy outcomes (APO) including spontaneous preterm delivery (sPTD) has been associated with up to a three-fold increased risk of maternal ASCVD later in life. However, little is known about the association between changes in vascular function associated with APOs and future maternal CVD risk.

Methods: We completed a case controlled, matched study, “Is Spontaneous Preterm Delivery Associated with Clustering of Future Maternal Cardiovascular Risk MarkErs?” (SPACE) enrolled 20 women with sPTD (gestation ≤34 weeks) and 20 control women (gestation ≥39 weeks) matched for age (�5 years), parity, race/ethnicity and route of delivery collected between 24-72 hours postpartum. Vascular function was measured by augmentation index corrected for heart rate 75 bpm (AIx75), central pulse pressure (CPP), and pulse wave velocity (PWV). Linear regression models were used to analyze the data.

Results: The mean age at enrollment for sPTD and controls was 33 � 6 years and 32 � 6 years respectively. Women with sPTD had significantly lower AIx75 compared to controls (24.10 � 16.10 % vs 39.90 � 15.2 %, p=0.001), respectively. In addition, CPP was significantly lower in sPTD compared to controls (29.1�5 mmHg vs. 34.6 �6 mmHg, respectively, p=0.004). Furthermore, women with sPTD and chorioamnionitis both clinically and/or on pathology report (n=8) had significantly lower AIx75 than matched controls (13.5 �13.7% vs 39.9 � 15.2% vs, p=0.001) respectively, while women with sPTD and no signs or symptoms of chorioamnionitis had a trend toward lower AIx75 than matched controls (26.6� 15.9 % vs. 39.9 � 15.2 %, p=0.065). There was no difference between sPTD and controls in PWV (5.12 � 1.62 m/s vs 5.58 � 1.51m/s, p=0.1219), respectively.