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Placental Abruption as a Risk Factor for Heart Failure
Jacqueline T DesJardin1, Michael J Healy2, Gregory Nah3
1Department of Medicine, University of California, San Francisco, California.
The American Journal of Cardiology
|July 29, 2020
Summary
Placental abruption, a severe pregnancy complication, increases the risk of heart failure (HF) in women. This risk is amplified by co-occurring hypertensive disorders of pregnancy and preterm birth.
Area of Science:
- Cardiovascular Disease Research
- Obstetrics and Gynecology
- Epidemiology
Background:
- Pregnancy complications can indicate future cardiovascular disease (CVD) risk.
- Placental abruption is a severe, understudied pregnancy complication with an unclear link to CVD.
Purpose of the Study:
- To investigate the association between placental abruption and cardiovascular disease (CVD) outcomes.
- To determine if placental abruption is a risk factor for myocardial infarction (MI), stroke, or heart failure (HF).
Main Methods:
- Utilized the California Healthcare Cost and Utilization Project database (2005-2011).
- Analyzed over 1.5 million pregnancies using Cox proportional-hazards regression.
- Adjusted for multiple covariates including demographics, medical comorbidities, and socioeconomic factors.
Main Results:
- Placental abruption occurred in 1% of pregnancies.
- In fully-adjusted models, placental abruption was significantly associated with an increased risk of heart failure (HR 1.44; 95% CI 1.09-1.90).
- Hypertensive disorders of pregnancy and preterm birth modified and mediated this association.
Conclusions:
- Placental abruption is an independent risk factor for heart failure.
- The association is particularly strong in women with co-existing hypertensive disorders of pregnancy and preterm birth.
- Identifying placental abruption aids in identifying women at high risk for future HF.
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