Pregnancy Complications Linked To Increased Risk Of Maternal Ischemic Heart Disease.

2001 JUL 12 -- (NewsRx Network) -- Two studies reported in the June 23, 2001, issue of the Lancet aim to evaluate the independent effect of intrauterine programming on the risk of cardiovascular disease.

Individuals who are small at birth are at increased risk of ischemic heart disease (IHD) in later life. One hypothesis to explain this association -- the Barker hypothesis -- is fetal adaptation to a suboptimum intrauterine environment. Gordon Smith and colleagues from the Queen Mother's Hospital, Glasgow, U.K., retrospectively investigated whether pregnancy complications associated with low birthweight were related to risk of subsequent maternal IHD.

Around 130,000 women in Scotland who had a first singleton delivery between 1981 and 1985 were studied. The risk of subsequent maternal IHD hospital admission or death was double for women whose babies were in the smallest 20% of birthweight for gestational age. A doubling of risk of maternal IHD was also independently associated with preterm delivery and with pre-eclampsia (high blood pressure during pregnancy).

Women with all three characteristics were seven times more likely to be admitted to hospital or die from IHD, reported Smith's team, and they propose that genetic predisposition may explain the association between low birthweight and subsequent maternal IHD.

In an accompanying editorial, Neil Poulter from Imperial College School of Medicine, London, U.K., cautioned that the emphasis on first-born babies and the absence of data on smoking may confound the results of the study.

"Confounding by parental characteristics, genetic or environmental, will only be eliminated in studies of monozygotic twins that investigate associations between anthropometric features within the twin-pairs and the development of a cardiovascular risk factor (i.e., hypertension or diabetes) or a cardiovascular event in later life," he ...