Adverse Pregnancy Outcomes and Maternal Chronic Diseases in the Future: A Cross-Sectional Study Using KoGES-HEXA Data

Abstract

Adverse pregnancy outcomes (APOs) are associated with an increased risk of chronic diseases, including cardiovascular disease (CVD) and metabolic syndrome (MS), in the future. We designed a large-scale cohort study to evaluate the influence of APOs (preeclampsia, gestational diabetes mellitus (GDM), stillbirth, macrosomia, and low birth weight) on the incidence of chronic diseases, body measurements, and serum biochemistry in the future and investigate whether combinations of APOs had additive effects on chronic diseases. We used health examinee data from the Korean Genome and Epidemiology Study (KoGES-HEXA) and extracted data of parous women (n = 30,174; mean age, 53.02 years) for the analysis. Women with APOs were more frequently diagnosed with chronic diseases and had a family history of chronic diseases compared with women without APOs. Composite APOs were associated with an increased risk of hypertension, diabetes mellitus, hyperlipidemia, angina pectoris, stroke, and MS (adjusted odds ratio: 1.093, 1.379, 1.269, 1.351, 1.414, and 1.104, respectively) after adjustment for family history and social behaviors. Preeclampsia and GDM were associated with an increased risk of some chronic diseases; however, the combination of preeclampsia and GDM did not have an additive effect on the risk. APOs moderately influenced the future development of maternal CVD and metabolic derangements, independent of family history and social behaviors.

Supporting reproductive health among birthing persons with chronic conditions in the United States: A qualitative multilevel study using systems thinking to inform action

“…Pregnant people with CC have a higher prevalence of preterm birth, low birth weight, and infant mortality, as well as an increased risk for some congenital anomalies 12,13,14 . Pregnancy itself is physiologically taxing and can exacerbate CC or trigger or reveal underlying pathology with resulting CC, including cardiometabolic and autoimmune conditions, of which women carry a particularly heavy burden 15,16–19 . In addition to risks during and after pregnancy, people with CC may experience discrimination and stigma when seeking reproductive health (RH) care due to their health status 20–25 .…”

“…12,13,14 Pregnancy itself is physiologically taxing and can exacerbate CC or trigger or reveal underlying pathology with resulting CC, including cardiometabolic and autoimmune conditions, of which women carry a particularly heavy burden. 15,[16][17][18][19] In addition to risks during and after pregnancy, people with CC may experience discrimination and stigma when seeking reproductive health (RH) care due to their health status. [20][21][22][23][24][25] A long history of reproductive injustice also shapes the way in which women and birthing people relate to RH decisions, resulting in women of color, those with LGBTQIA+ status, and other minoritized women with CC facing reproductive discrimination from providers and health systems due to their intersecting identities.…”