000			04274nam a22005897a 4500
008			220124s20202020 xxu||||| |||| 00| 0 eng d
024			_a10.1001/jamacardio.2020.4097 [doi]
024			_a2770501 [pii]
024			_aPMC7495331 [pmc]
040			_aOvid MEDLINE(R)
099			_a32936228
245			_aAssociation of Adverse Pregnancy Outcomes With Risk of Atherosclerotic Cardiovascular Disease in Postmenopausal Women.
251			_aJAMA Cardiology. 5(12):1390-1398, 2020 12 01.
252			_aJAMA Cardiol. 5(12):1390-1398, 2020 12 01.
252			_zJAMA Cardiol. 5(12):1390-1398, 2020 12 01.
253			_aJAMA cardiology
260			_c2020
260			_fFY2021
260			_p2020 12 01
265			_sppublish
266			_d2020-10-06
268			_aJAMA Cardiology. 5(12):1390-1398, 2020 12 01.
269			_fFY2021
520			_aConclusions and Relevance: In this large multiethnic cohort of women, hypertensive disorders of pregnancy and low birth weight were independently associated with ASCVD after adjustment for risk factors and other APOs.
520			_aDesign, Setting, and Participants: The APO history among participants in the Women's Health Initiative, a large multiethnic cohort of postmenopausal women, was assessed. The associations of 5 self-reported APOs (gestational diabetes, hypertensive disorders of pregnancy, low birth weight [ie, birth weight less than 2.49 kg], high birth weight [ie, birth weight greater than 4.08 kg], and preterm delivery by 3 weeks or more) with ASCVD were analyzed, adjusting for traditional ASCVD risk factors. Data were collected and analyzed in 2017.
520			_aExposures: APOs (gestational diabetes, hypertensive disorders of pregnancy, low birth weight, high birth weight, and preterm delivery).
520			_aImportance: Atherosclerotic cardiovascular disease (ASCVD) may have unique risk factors in women. Most women have a history of pregnancy; common adverse pregnancy outcomes (APOs) appear to be associated with ASCVD, but prior studies have limitations.
520			_aMain Outcomes and Measures: Adjudicated ASCVD.
520			_aObjective: To assess whether APOs are associated with increased ASCVD risk independently of traditional risk factors.
520			_aResults: A total of 48113 Women's Health Initiative participants responded to the survey; the median (interquartile range) age at time of enrollment was 60.0 (55.0-64.0) years. A total of 13482 participants (28.8%) reported 1 or more APOs. Atherosclerotic cardiovascular disease was more frequent in women who reported an APO compared with those without APOs (1028 of 13 482 [7.6%] vs 1758 of 30 522 [5.8%]). Each APO, analyzed separately, was significantly associated with ASCVD, and gestational diabetes, hypertensive disorders of pregnancy, low birth weight, and preterm delivery remained significant after adjustment for traditional ASCVD risk factors. When all APOs were analyzed together, hypertensive disorders of pregnancy (odds ratio, 1.27; 95% CI, 1.15-1.40) and low birth weight (odds ratio, 1.12; 95% CI, 1.00-1.26) remained independently associated with ASCVD. All findings were materially unchanged by additional adjustment for parity, body mass index, and socioeconomic factors.
546			_aEnglish
650			_a*Atherosclerosis/ep [Epidemiology]
650			_a*Pregnancy Complications, Cardiovascular/ep [Epidemiology]
650			_a*Pregnancy Outcome
650			_aFemale
650			_aHumans
650			_aMiddle Aged
650			_aPostmenopause
650			_aPregnancy
650			_aProspective Studies
650			_aRisk Assessment
650			_aRisk Factors
650			_aSelf Report
651			_aMedStar Heart & Vascular Institute
657			_aJournal Article
657			_aResearch Support, N.I.H., Extramural
657			_aResearch Support, Non-U.S. Gov't
700			_aValdiviezo, Carolina
790			_aAllison M, Gemmill A, Hlatky MA, Manson JE, Nah G, Parikh NI, Park K, Salmoirago-Blotcher E, Sattari M, Sealy-Jefferson S, Shadyab AH, Sondergaard MM, Stefanick ML, Valdiviezo C, Van Horn L, Vittinghoff E
856			_uhttps://dx.doi.org/10.1001/jamacardio.2020.4097 _zhttps://dx.doi.org/10.1001/jamacardio.2020.4097
942			_cART _dArticle
999			_c5565 _d5565