(517) Socioeconomic status and adverse pregnancy outcome increase risk of long-term cardiovascular disease, analyzing long-term cohort

Adverse pregnancy outcomes (APO) have been reported to increase the risk of long-term atherosclerotic cardiovascular disease (ASCVD) later in life. Additionally, socioeconomic status (SES) is known to be associated with ASCVD risk. In the current analysis, we determined the interaction between SES and APO, specifically, if low SES further aggravates the ASCVD risk after APO.

Study Design:

We conducted the current analysis using data from the UK Biobank, which is a large prospective cohort. This data includes participants in age 40 to 69 years recruited between 2006 and 2010, with ongoing follow-up. APO included hypertensive disease during pregnancy (HDP), gestational diabetes mellitus (GDM), and low birth weight ( < 2.5kg). SES was analyzed using the following indicators; household income, education, employment and Townsend Deprived Score. The study population were categorized into four main groups according to APO and SES: no APO/high SES, APO/high SES, no APO/low SES and APO/low SES groups. The incidence of long-term ASCVD events and the cumulative hazard risk (HR) for ASCVD was analyzed according to the APO and SES categories.

Results: In total, 219,147 female participants were analyzed. The results indicated that the APO group had relatively lower SES in all indicators and higher incidence of ASCVD, hypertension, hyperlipidemia, diabetes mellitus, compared to the no APO group. After adjusting for the confounding factors, the risk of ASCVD was highest in the group with APO and low SES group. Specifically, the HR was 2.029 (95 % CI, 1.762-2.338, p < 0.001) in those with APO and unemployment.

Conclusion: We found that the CVD risk varied according to SES and APO. This study suggests the importance for support policies tailored to individuals’ SES to prevent APO and improve long-term cardiovascular disease.