Maternal Obesity during Pregnancy and Premature Cardiovascular Mortality in Later Life

Kuan Ken Lee, Edwin ARaja, Amanda J Lee, Sohinee Bhattacharya, Siladitya Bhattacharya, Jane E Norman, Rebecca M Reynolds

Research output: Contribution to journalArticle

Abstract

INTRODUCTION: One in five women in the United Kingdom is obese at antenatal booking. We aimed to determine whether maternal obesity during pregnancy is associated with increased mortality from cardiovascular events in later life.

METHODS: Maternity records of women who gave birth to their first child between 1950 and 1976 (n = 18,912) from the Aberdeen Maternity and Neonatal databank were linked to the General Register of Deaths, Scotland and the Scottish Morbidity Record systems. Death and hospital admissions for cardiovascular events up to 1 January 2012 were recorded with median follow-up of 50 years. Maternal body mass index (BMI) was calculated from height and weight measured at the first antenatal visit. The effect of maternal obesity on outcomes was tested with time to event analysis with Cox proportional hazard regression to compare outcomes of mothers in underweight, overweight, or obese categories of BMI as recommended by WHO compared to mothers with normal BMI.

RESULTS: All-cause mortality was increased in obese mothers (BMI >30kg/m(2)) compared with mothers with normal BMI after adjustment for maternal age at delivery, socioeconomic status, smoking status, gestational age at BMI measurement, pre-eclampsia and low birth weight (hazard ratio 1.35, 95% CI: 1.02-1.78). In adjusted models, overweight and obese mothers have increased risk of major cardiovascular events, MACE (1.12, 1.01-1.24 and 1.37, 1.07-1.75 respectively) and hospital admission for a cardiovascular event (1.27, 1.16-1.39 and 1.49, 1.19-1.86) compared to mothers with normal BMI. Underweight mothers also had increased risk of MACE (1.21, 1.00-1.45), suggesting a possible J-shaped relationship.

CONCLUSIONS: Maternal obesity is associated with an increased risk of premature death and cardiovascular disease in later life. Pregnancy is a key time when women receive input from health care professionals and are motivated to improve their health. This period could represent a window of opportunity for interventions to reduce obesity. heartjnl;100/Suppl_3/A65-c/F1F1F1 Abstract 115 Figure 1 Kaplan-Meier curves for death rates according to maternal BMI heartjnl;100/Suppl_3/A65-c/F2F2F2 Abstract 115 Figure 2 Kaplan-Meier curves for MACE according to maternal BMI.

Original languageEnglish
Pages (from-to)A65-66
Number of pages2
JournalHeart
Volume100
Issue numberSuppl 3
DOIs
Publication statusPublished - Jun 2014

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Premature Mortality
Obesity
Mothers
Pregnancy
Body Mass Index
Thinness
Mortality
Maternal Age
Scotland
Low Birth Weight Infant
Pre-Eclampsia
Social Class
Gestational Age
Cardiovascular Diseases

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Maternal Obesity during Pregnancy and Premature Cardiovascular Mortality in Later Life. / Lee, Kuan Ken; ARaja, Edwin; Lee, Amanda J; Bhattacharya, Sohinee; Bhattacharya, Siladitya; Norman, Jane E; Reynolds, Rebecca M.

In: Heart, Vol. 100 , No. Suppl 3, 06.2014, p. A65-66.

Research output: Contribution to journalArticle

Lee, KK, ARaja, E, Lee, AJ, Bhattacharya, S, Bhattacharya, S, Norman, JE & Reynolds, RM 2014, 'Maternal Obesity during Pregnancy and Premature Cardiovascular Mortality in Later Life', Heart, vol. 100 , no. Suppl 3, pp. A65-66. https://doi.org/10.1136/heartjnl-2014-306118.115
Lee, Kuan Ken ; ARaja, Edwin ; Lee, Amanda J ; Bhattacharya, Sohinee ; Bhattacharya, Siladitya ; Norman, Jane E ; Reynolds, Rebecca M. / Maternal Obesity during Pregnancy and Premature Cardiovascular Mortality in Later Life. In: Heart. 2014 ; Vol. 100 , No. Suppl 3. pp. A65-66.
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abstract = "INTRODUCTION: One in five women in the United Kingdom is obese at antenatal booking. We aimed to determine whether maternal obesity during pregnancy is associated with increased mortality from cardiovascular events in later life.METHODS: Maternity records of women who gave birth to their first child between 1950 and 1976 (n = 18,912) from the Aberdeen Maternity and Neonatal databank were linked to the General Register of Deaths, Scotland and the Scottish Morbidity Record systems. Death and hospital admissions for cardiovascular events up to 1 January 2012 were recorded with median follow-up of 50 years. Maternal body mass index (BMI) was calculated from height and weight measured at the first antenatal visit. The effect of maternal obesity on outcomes was tested with time to event analysis with Cox proportional hazard regression to compare outcomes of mothers in underweight, overweight, or obese categories of BMI as recommended by WHO compared to mothers with normal BMI.RESULTS: All-cause mortality was increased in obese mothers (BMI >30kg/m(2)) compared with mothers with normal BMI after adjustment for maternal age at delivery, socioeconomic status, smoking status, gestational age at BMI measurement, pre-eclampsia and low birth weight (hazard ratio 1.35, 95{\%} CI: 1.02-1.78). In adjusted models, overweight and obese mothers have increased risk of major cardiovascular events, MACE (1.12, 1.01-1.24 and 1.37, 1.07-1.75 respectively) and hospital admission for a cardiovascular event (1.27, 1.16-1.39 and 1.49, 1.19-1.86) compared to mothers with normal BMI. Underweight mothers also had increased risk of MACE (1.21, 1.00-1.45), suggesting a possible J-shaped relationship.CONCLUSIONS: Maternal obesity is associated with an increased risk of premature death and cardiovascular disease in later life. Pregnancy is a key time when women receive input from health care professionals and are motivated to improve their health. This period could represent a window of opportunity for interventions to reduce obesity. heartjnl;100/Suppl_3/A65-c/F1F1F1 Abstract 115 Figure 1 Kaplan-Meier curves for death rates according to maternal BMI heartjnl;100/Suppl_3/A65-c/F2F2F2 Abstract 115 Figure 2 Kaplan-Meier curves for MACE according to maternal BMI.",
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T1 - Maternal Obesity during Pregnancy and Premature Cardiovascular Mortality in Later Life

AU - Lee, Kuan Ken

AU - ARaja, Edwin

AU - Lee, Amanda J

AU - Bhattacharya, Sohinee

AU - Bhattacharya, Siladitya

AU - Norman, Jane E

AU - Reynolds, Rebecca M

N1 - © 2014, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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Y1 - 2014/6

N2 - INTRODUCTION: One in five women in the United Kingdom is obese at antenatal booking. We aimed to determine whether maternal obesity during pregnancy is associated with increased mortality from cardiovascular events in later life.METHODS: Maternity records of women who gave birth to their first child between 1950 and 1976 (n = 18,912) from the Aberdeen Maternity and Neonatal databank were linked to the General Register of Deaths, Scotland and the Scottish Morbidity Record systems. Death and hospital admissions for cardiovascular events up to 1 January 2012 were recorded with median follow-up of 50 years. Maternal body mass index (BMI) was calculated from height and weight measured at the first antenatal visit. The effect of maternal obesity on outcomes was tested with time to event analysis with Cox proportional hazard regression to compare outcomes of mothers in underweight, overweight, or obese categories of BMI as recommended by WHO compared to mothers with normal BMI.RESULTS: All-cause mortality was increased in obese mothers (BMI >30kg/m(2)) compared with mothers with normal BMI after adjustment for maternal age at delivery, socioeconomic status, smoking status, gestational age at BMI measurement, pre-eclampsia and low birth weight (hazard ratio 1.35, 95% CI: 1.02-1.78). In adjusted models, overweight and obese mothers have increased risk of major cardiovascular events, MACE (1.12, 1.01-1.24 and 1.37, 1.07-1.75 respectively) and hospital admission for a cardiovascular event (1.27, 1.16-1.39 and 1.49, 1.19-1.86) compared to mothers with normal BMI. Underweight mothers also had increased risk of MACE (1.21, 1.00-1.45), suggesting a possible J-shaped relationship.CONCLUSIONS: Maternal obesity is associated with an increased risk of premature death and cardiovascular disease in later life. Pregnancy is a key time when women receive input from health care professionals and are motivated to improve their health. This period could represent a window of opportunity for interventions to reduce obesity. heartjnl;100/Suppl_3/A65-c/F1F1F1 Abstract 115 Figure 1 Kaplan-Meier curves for death rates according to maternal BMI heartjnl;100/Suppl_3/A65-c/F2F2F2 Abstract 115 Figure 2 Kaplan-Meier curves for MACE according to maternal BMI.

AB - INTRODUCTION: One in five women in the United Kingdom is obese at antenatal booking. We aimed to determine whether maternal obesity during pregnancy is associated with increased mortality from cardiovascular events in later life.METHODS: Maternity records of women who gave birth to their first child between 1950 and 1976 (n = 18,912) from the Aberdeen Maternity and Neonatal databank were linked to the General Register of Deaths, Scotland and the Scottish Morbidity Record systems. Death and hospital admissions for cardiovascular events up to 1 January 2012 were recorded with median follow-up of 50 years. Maternal body mass index (BMI) was calculated from height and weight measured at the first antenatal visit. The effect of maternal obesity on outcomes was tested with time to event analysis with Cox proportional hazard regression to compare outcomes of mothers in underweight, overweight, or obese categories of BMI as recommended by WHO compared to mothers with normal BMI.RESULTS: All-cause mortality was increased in obese mothers (BMI >30kg/m(2)) compared with mothers with normal BMI after adjustment for maternal age at delivery, socioeconomic status, smoking status, gestational age at BMI measurement, pre-eclampsia and low birth weight (hazard ratio 1.35, 95% CI: 1.02-1.78). In adjusted models, overweight and obese mothers have increased risk of major cardiovascular events, MACE (1.12, 1.01-1.24 and 1.37, 1.07-1.75 respectively) and hospital admission for a cardiovascular event (1.27, 1.16-1.39 and 1.49, 1.19-1.86) compared to mothers with normal BMI. Underweight mothers also had increased risk of MACE (1.21, 1.00-1.45), suggesting a possible J-shaped relationship.CONCLUSIONS: Maternal obesity is associated with an increased risk of premature death and cardiovascular disease in later life. Pregnancy is a key time when women receive input from health care professionals and are motivated to improve their health. This period could represent a window of opportunity for interventions to reduce obesity. heartjnl;100/Suppl_3/A65-c/F1F1F1 Abstract 115 Figure 1 Kaplan-Meier curves for death rates according to maternal BMI heartjnl;100/Suppl_3/A65-c/F2F2F2 Abstract 115 Figure 2 Kaplan-Meier curves for MACE according to maternal BMI.

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DO - 10.1136/heartjnl-2014-306118.115

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VL - 100

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JO - Heart

JF - Heart

SN - 1355-6037

IS - Suppl 3

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