| Titre : | Maternal risk of ischaemic heart disease following elective and spontaneous pre-term delivery : retrospective cohort study of 750350 singleton pregnancies. (2011) |
| Auteurs : | HASTIE (Claire-E) : GBR. British Heart Foundation Cardiovascular Research Centre. University of Glasgow. ; MACKAY (Daniel-F) : GBR. Section of Public Health. University of Glasgow. ; PELL (Jill-P) : GBR. Section of Public Health. University of Glasgow. ; Gordon-Cs Smith |
| Type de document : | Article |
| Dans : | International journal of epidemiology (vol. 40, n° 4, 2011) |
| Pagination : | 914-919 |
| Langues: | Anglais |
| Mots-clés : | Cardiopathie coronaire ; Facteur risque ; Epidémiologie ; Ecosse ; Prématurité ; Homme ; Grande Bretagne ; Europe |
| Résumé : | [BDSP. Notice produite par INIST-CNRS C88JAR0x. Diffusion soumise à autorisation]. Background Previous studies have demonstrated an overall association between pre-term delivery and maternal risk of subsequent ischaemic heart disease (IHD). The underlying mechanism is unknown. We explored whether the association was specific to spontaneous or elective pre-term delivery. Methods We linked three Scottish routine data sources. The Scottish Morbidity Record 1 collects data on all acute hospital admissions, Scottish Morbidity Record 2 collects data on all pregnancies and Scotland's Registrar General collates data from all death certificates. Cox proportional hazards models were used to explore associations between pre-term delivery and subsequent IHD events (fatal and non-fatal) and IHD deaths. Analysis was restricted to women aged between 35 and 65 years at either the time of their first IHD event or at the end of follow-up. Results The cohort comprised 750350 women who delivered a live, singleton infant following their first pregnancy. We demonstrated independent associations between pre-term delivery and IHD death [hazards ratio (HR) 2.26,95% confidence interval (CI) 1.88-2.71] and total IHD events (HR 1.58,95% CI 1.47-1.71). Associations were greater for elective than spontaneous pre-term delivery (P=0.005). There was a trend whereby the association between pre-term delivery and IHD increased with decreasing age at first event. Conclusions We observed a stronger association between elective pre-term delivery and IHD, than spontaneous pre-term delivery and IHD. Elective pre-term delivery is usually undertaken because of growth restriction or pre-eclampsia, resulting from placental dysfunction. The age trend observed suggests an underlying genetic predisposition to both placental dysfunction and IHD. |
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