Primary atherothrombotic occlusive vascular events in premenopausal women with history of adverse pregnancy outcome.

OBJECTIVE

To determine if adverse pregnancy outcomes are associated with atherothrombotic occlusive vascular disease (AOVD) in premenopausal women.

DESIGN

Retrospective matched case-control study.

SETTING

Tertiary, university-affiliated medical center.

POPULATION: Women aged less than 50 years treated for an AOVD (primary cerebrovascular, myocardial, or peripheral arterial ischemic event) from 1995 to 2004.

METHOD: The files were reviewed for classical risk factors for AOVD and complications of pregnancy (abortions, pregnancy-induced hypertension, preeclampsia, gestational diabetes, intrauterine growth restriction (IUGR), fetal loss and preterm delivery). Findings were compared with healthy women matched for age and body mass index.

MAIN OUTCOME MEASURES: Past pregnancy complications in premenopausal women with AOVD.

RESULTS

Of the 101 women with AOVD, 53 had a myocardial ischemic event, 33 a cerebrovascular event, and 15 a peripheral ischemic arterial event. On multivariate analysis, IUGR (OR 8.41, 95% CI 2.36-29.9, p=0.001) and more than one pregnancy complication (OR 13.7, 95% CI 1.56-120, p=0.02) were found to be independent significant variables associated with AOVD.

CONCLUSION

IUGR and composite pregnancy complications are independent significant variables associated with AOVD in premenopausal period. Pregnancy outcome might serve as a means to identify patients who may require increased medical surveillance and preventive measures for later vascular disease.