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Obstetrical Complications and Long-Term Cardiovascular Outcomes

  • Preeclampsia (VD Garovic, Section Editor)
  • Published:
Current Hypertension Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Obstetrical complications including indicated preterm birth (PTB), hypertension (HTN), IUGR, and GDM are risk factors for future cardiovascular disease. To identify patients at risk, the American Heart Association recommends obtaining a detailed obstetric history. Our objective was to determine if non-OB-GYN physicians-in-training obtain an obstetric history when assessing a risk profile for cardiovascular disease and to identify differences based on level of training. In 2019, an anonymous survey was distributed to trainees in internal medicine, cardiology, endocrinology, nephrology, and neurology. Subjects were queried about frequency of asking a history of PTB, IUGR, GDM, and HTN in pregnancy. Survey options were always/frequently/sometimes/rarely/never and were categorized into two groups: “ask” (always/frequently/sometimes) vs. “do not ask” (rarely/never). Comparisons between specialties and levels of training were made using chi-square and Fisher’s exact test. Comparisons within subjects were made using McNemar’s test.

Recent Findings

The response rate was 64% (210 total possible participants), including 98 internal medicine residents and 37 fellows in cardiology (21), endocrinology (3), nephrology (8), and neurology (5). Asking about medical complications (HTN + GDM) was significantly more common than asking about OB complications (PTB + IUGR) (p < 0.001). Internal medicine residents were less likely than subspecialty fellows to ask about HTN (31% vs. 70%; p < 0.001). There were no differences in likelihood of eliciting OB history based on PGY level.

Summary

An OB history can identify risk factors for cardiovascular morbidity. Our data demonstrates that physicians caring for women lack awareness on the association between complications in pregnancy and cardiovascular health.

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Abbreviations

AHA:

American Heart Association

GDM:

Gestational diabetes mellitus

HTN:

Hypertension

IUGR:

Intrauterine growth restriction

OB:

Obstetric

OB-GYN:

Obstetrics and gynecology

PTB:

Preterm birth

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, Weill Cornell Medicine, 525 East 68th Street Box 122, New York, NY, 10065, USA

    Megan Savage & Stephen Chasen

  2. Department of Medicine, Weill Cornell Medicine, New York, NY, USA

    Diala Steitieh

  3. Division of Cardiology, Department of Medicine, Weill Cornell Medicine, New York, NY, USA

    Nivee Amin

  4. Division of Nephrology & HTN, Department of Medicine, Weill Cornell Medicine, New York, NY, USA

    Line Malha

Authors
  1. Megan Savage
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  2. Diala Steitieh
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  3. Nivee Amin
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  4. Line Malha
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  5. Stephen Chasen
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Corresponding author

Correspondence to Megan Savage.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Ethical Standards

This study was deemed exempt by the Weill Cornell College of Medicine Institutional Review Board (protocol #19-04020247), with a waiver of informed consent.

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This article is part of the Topical Collection on Preeclampsia

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Savage, M., Steitieh, D., Amin, N. et al. Obstetrical Complications and Long-Term Cardiovascular Outcomes. Curr Hypertens Rep 22, 92 (2020). https://doi.org/10.1007/s11906-020-01102-9

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  • DOI: https://doi.org/10.1007/s11906-020-01102-9

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