Prepregnancy Obesity and Associations With Stroke and Myocardial Infarction in Women in the Years After Childbirth: a nationwide cohort study

TY - JOUR

T1 - Prepregnancy Obesity and Associations With Stroke and Myocardial Infarction in Women in the Years After Childbirth

T2 - a nationwide cohort study

AU - Schmiegelow, Michelle Dalgas

AU - Andersson, Charlotte

AU - Køber, Lars

AU - Andersen, Søren Skøtt

AU - Olesen, Jonas Bjerring

AU - Jensen, Thomas Bo

AU - Azimi, Aziza

AU - Nielsen, Mia Birgitte

AU - Gislason, Gunnar

AU - Torp-Pedersen, Christian

PY - 2014/1/21

Y1 - 2014/1/21

N2 - Background-Cardiovascular events (stroke or myocardial infarction) are often associated with poorer prognosis in younger, compared with older individuals. We examined the associations between prepregnancy obesity and the risks of myocardial infarction and stroke in young, healthy women. Methods and Results-All Danish women giving birth during 2004-2009 without a history of renal disease or cardiovascular disease were identified from national registers and followed for a median time of 4.5 years (interquartile range, 2.8-5.8). They were grouped according to prepregnancy body mass index (BMI) in underweight (BMI<18.5 kg/m2), normal weight (BMI=18.5-<25 kg/m 2), overweight (BMI=25-<30 kg/m2), and obese (BMI≥30 kg/m2). The hazard ratios of myocardial infarction, ischemic stroke, and a composite outcome (myocardial infarction, stroke, cardiovascular death) were assessed using multivariable Cox regression models. We included 273 101 women with a median age of 30.4 years (interquartile range, 27.2-33.8). A total of 68 women experienced a myocardial infarction, and 175 women experienced an ischemic stroke. The adjusted hazard ratios of myocardial infarction compared with normal weight were 2.50 (95% confidence interval [95% CI], 0.97-6.50) in underweight, 1.68 (95% CI, 0.92-3.06) in overweight, and 2.63 (95% CI, 1.41-4.91) in obese women. For ischemic stroke the adjusted hazard ratios were 1.06 (95% CI, 0.44-2.28) in underweight, 1.27 (95% CI, 0.87-1.85) in overweight, and 1.89 (95% CI, 1.25-2.84) in obese women, respectively. For the composite outcome, hazard ratios were 1.34 (95% CI, 0.81-2.20), 1.43 (95% CI, 1.11-1.84), and 1.76 (95% CI, 1.31-2.34) for underweight, overweight, and obese women. Conclusions-In apparently healthy women of fertile age, prepregnancy obesity was associated with increased risks of ischemic stroke and myocardial infarction in the years after childbirth.

AB - Background-Cardiovascular events (stroke or myocardial infarction) are often associated with poorer prognosis in younger, compared with older individuals. We examined the associations between prepregnancy obesity and the risks of myocardial infarction and stroke in young, healthy women. Methods and Results-All Danish women giving birth during 2004-2009 without a history of renal disease or cardiovascular disease were identified from national registers and followed for a median time of 4.5 years (interquartile range, 2.8-5.8). They were grouped according to prepregnancy body mass index (BMI) in underweight (BMI<18.5 kg/m2), normal weight (BMI=18.5-<25 kg/m 2), overweight (BMI=25-<30 kg/m2), and obese (BMI≥30 kg/m2). The hazard ratios of myocardial infarction, ischemic stroke, and a composite outcome (myocardial infarction, stroke, cardiovascular death) were assessed using multivariable Cox regression models. We included 273 101 women with a median age of 30.4 years (interquartile range, 27.2-33.8). A total of 68 women experienced a myocardial infarction, and 175 women experienced an ischemic stroke. The adjusted hazard ratios of myocardial infarction compared with normal weight were 2.50 (95% confidence interval [95% CI], 0.97-6.50) in underweight, 1.68 (95% CI, 0.92-3.06) in overweight, and 2.63 (95% CI, 1.41-4.91) in obese women. For ischemic stroke the adjusted hazard ratios were 1.06 (95% CI, 0.44-2.28) in underweight, 1.27 (95% CI, 0.87-1.85) in overweight, and 1.89 (95% CI, 1.25-2.84) in obese women, respectively. For the composite outcome, hazard ratios were 1.34 (95% CI, 0.81-2.20), 1.43 (95% CI, 1.11-1.84), and 1.76 (95% CI, 1.31-2.34) for underweight, overweight, and obese women. Conclusions-In apparently healthy women of fertile age, prepregnancy obesity was associated with increased risks of ischemic stroke and myocardial infarction in the years after childbirth.

KW - Adult

KW - Brain Ischemia

KW - Cohort Studies

KW - Denmark

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Incidence

KW - Male

KW - Myocardial Infarction

KW - Obesity

KW - Overweight

KW - Pregnancy

KW - Pregnancy Complications

KW - Prognosis

KW - Proportional Hazards Models

KW - Registries

KW - Risk Factors

KW - Smoking

KW - Stroke

U2 - 10.1161/circulationaha.113.003142

DO - 10.1161/circulationaha.113.003142

M3 - Journal article

C2 - 24146252

SN - 0009-7322

VL - 129

SP - 330

EP - 337

JO - Circulation

JF - Circulation

IS - 3

ER -