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Single‐Multiple and Recurrent Pregnancy‐Related Complications and Incident Cardiovascular Disease: A Nationwide Data Linkage Study in Wales, UK

Tariq Al Bahhawi Orcid Logo, Stephanie L. Harrison, Deirdre A. Lane Orcid Logo, Flemming Skjøth Orcid Logo, Iain Buchan Orcid Logo, Andrew Sharp Orcid Logo, Hoda Abbasizanjani Orcid Logo, Ashley Akbari Orcid Logo, Fatemeh Torabi Orcid Logo, Julian Halcox Orcid Logo, Dharani K. Hapangama Orcid Logo, Gregory Y. H. Lip Orcid Logo

Journal of the American Heart Association, Volume: 15, Issue: 5

Swansea University Authors: Hoda Abbasizanjani Orcid Logo, Ashley Akbari Orcid Logo, Fatemeh Torabi Orcid Logo, Julian Halcox Orcid Logo

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Abstract

Background: Pregnancy‐related complications are linked to increased cardiovascular disease risk, but comprehensive evaluations of diverse complications, particularly multiple or recurrent events, are limited. Methods: A national retrospective cohort study was conducted using the Secure Anonymised In...

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Published in: Journal of the American Heart Association
ISSN: 2047-9980
Published: Ovid Technologies (Wolters Kluwer Health) 2026
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa71647
Abstract: Background: Pregnancy‐related complications are linked to increased cardiovascular disease risk, but comprehensive evaluations of diverse complications, particularly multiple or recurrent events, are limited. Methods: A national retrospective cohort study was conducted using the Secure Anonymised Information Linkage (SAIL) Databank in Wales. Exposures were hypertensive disorders of pregnancy, gestational diabetes, placental abruption, stillbirth, small for gestational age, fetal growth restriction, and preterm birth. Multiple complications were defined as >1 complication in the first pregnancy, and recurrent complications as the same complication in both the first and second pregnancies. Outcomes were incident ischemic heart disease, stroke, heart failure, and atrial fibrillation. Cox regression estimated hazard ratios (HRs). Results: A total of 298 515 women (mean age 27.2 years; SD 6.1) were included. Multiple pregnancy‐related complications were associated with increased risk of ischemic heart disease (hazard ratio HR, 2.88 [95% CI, 2.27–3.67]), stroke (HR, 2.03 [95% CI, 1.55–2.65]), heart failure (HR, 3.18 [95% CI, 2.34–4.32]), and atrial fibrillation (HR, 1.80 [95% CI, 1.20–2.72]) compared with no complications. A dose–response relationship was observed, with progressively higher cardiovascular disease risk for multiple compared with single complications and elevated risk for both groups relative to women without complications. Recurrent pregnancy‐related complications increased the risk of ischemic heart disease (HR, 1.93 [95% CI, 1.26–2.95]), stroke (HR, 1.89 [95% CI, 1.25–2.85]), heart failure (HR, 3.61 [95% CI, 2.32–5.60]), and atrial fibrillation (HR, 2.45 [95% CI, 1.38–4.37]) compared with no complication. Conclusions: Women experiencing pregnancy‐related complications encounter higher risks of cardiovascular disease, especially with multiple or recurrent complications. Comprehensive cardiovascular risks assessment and targeted prevention should be prioritized for this group.
Keywords: atrial fibrillation; cardiovascular disease; pregnancy complications; recurrent pregnancy complications
College: Faculty of Medicine, Health and Life Sciences
Funders: Tariq Al Bahhawi is supported by a PhD scholarship from Jazan University for postgraduate studies. Gregory Y. H. Lip and Iain Buchan (NIHR205131) are supported by the National Institute for Health and Care Research
Issue: 5