Heart failure & cardiomyopathiesCohort study
Adverse Pregnancy Outcomes and Long-Term Risk of Heart Failure in Women
- Retrospective cohort study
- national
- population-based
- co-sibling analyses
Authors' conclusion
In this large national cohort, women who experienced any of 5 major adverse pregnancy outcomes had increased risk for HF up to 46 years later.
Study context
- Population
- Women with a singleton delivery in Sweden, 1973–2015, followed for heart failure (HF) through 2018667,774 (30%) with adverse outcome
- Participants
- 2,201,638 women
- Exposure
- Adverse pregnancy outcomes vs none
- Outcome
- HF (nationwide outpatient and inpatient diagnoses)
- Follow-up
- Up to 46 years after delivery
Main finding
As reported in the abstract
HF
Adjusted hazard ratio (95% CI)
Gestational diabetes
2.19(1.95–2.45)
Preterm delivery
1.68(1.61–1.75)
Other hypertensive disorders
1.68(1.48–1.90)
Preeclampsia
1.59(1.53–1.66)
Small for gestational age
1.35(1.31–1.40)
- HF diagnosed (median age, 61 years)
- 19,922 (0.9%)
Observational data: associations, not effects.
Further findings
HF by number of adverse pregnancy outcomes · up to 46 years after delivery
| Comparison | adjusted HR (95% CI) | |
|---|---|---|
| 1 | 1.51 (1.47–1.56) | |
| 2 | 2.31 (2.19–2.45) | |
| ≥3 | 3.18 (2.85–3.56) | |
| 0.20.5125Adjusted hazard ratio (log scale) |
HF 30 to 46 years after delivery
- All HRs remained significantly elevated
- 1.3- to 3.0-fold
Co-sibling analyses
- Findings only partially explained by shared familial factors
Original publication
Adverse Pregnancy Outcomes and Long-Term Risk of Heart Failure in Women. JACC Heart Fail. Published 22 January 2025. doi:10.1016/j.jchf.2024.11.004
Summarised from the published abstract; every number is checked against it