Obese Pregnant Patients May Benefit From Cardio Risk Screening

In a study presented today at the Society for Maternal-Fetal Medicine’s 34^th annual meeting, The Pregnancy Meeting™, in New Orleans, researchers reported that obesity during pregnancy is an independent risk factor for long-term cardiovascular morbidity, and these complications tend to occur at a younger age. Considering their findings, the researchers concluded that obese pregnant patients might benefit from cardiovascular risk screening that could lead to early detection and secondary prevention of cardiovascular morbidity. 

"As obstetricians, we should remember to consult our obese patients not only for possible obstetrical issues but also for long-term cardiovascular complications. Pregnancy is a unique window of opportunity which has an important role in promoting lifestyle modifications." 
-Shimrit Yaniv Salem, MD

Obesity is considered a chronic disease with a dramatic increase in its prevalence worldwide during the past 2 decades. Close to a third of women of childbearing age are classified as obese, and an additional 25% of women in this age group are classified as overweight. Maternal pre-pregnancy obesity is a significant risk factor for adverse obstetrical and perinatal outcomes.

To determine whether obesity in pregnancy is an independent risk factor for long-term subsequent maternal cardiovascular morbidity, researchers evaluated data from pregnant women who delivered between 1988 and 1999 and were followed up retrospectively until 2010. Long-term cardiovascular morbidity was compared among women with and without obesity in pregnancy (defined as maternal pre-pregnancy BMI of 30 kg/m² or more). Cardiovascular morbidity was divided into 4 categories, which included simple and complex cardiovascular events and invasive and noninvasive cardiac procedures.

During the study period, 46,688 women who delivered were recruited; of that number, 1,221 women were obese. Ten years later, compared with nonobese patients, these obese patients had higher rates of simple cardiovascular events (5.1% vs 2.6%), noninvasive diagnostic procedures (2.0% vs 1.1%), and total number of cardiovascular-related hospitalizations (6.6% vs 3.6%).

The data recovered not only indicates an association between obesity in pregnancy and future risk for cardiovascular morbidity but also reveals the effect of obesity in pregnancy on earlier occurrence of cardiovascular morbidity.

Study author Shimrit Yaniv Salem, MD, department of obstetrics and gynecology, faculty of health sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Be’er Sheva, Israel, said, “These results are of major importance to the obstetricians counseling a patient regarding future risk for cardiovascular complications. It is important for secondary prevention, early detection, and specific screening programs for this population. As obstetricians, we should remember to consult our obese patients not only for possible obstetrical issues but also for long-term cardiovascular complications. Pregnancy is a unique window of opportunity which has an important role in promoting life style modifications.”