Cardiovascular Risk in Women with Adverse Pregnancy Outcomes

Aims: Identify cardiovascular risk factors and to estimate the risk of cardiovascular events in women presenting with APO.

Study Design: Cross-sectional study.

Place and Duration of Study: Two maternity wards in Lubumbashi (University Clinics of Lubumbashi and Jason Sendwe Provincial General Reference Hospital), between August 2023 and February 2024.

Methodology: We included 125 women with adverse pregnancy outcomes (APO). The participants were residents of Lubumbashi and provided informed consent for the study. Excluded were those with incomplete clinical or biological data due to refusal to participate or death, and those with known cardiovascular diseases. Clinical examination included detailed anamnesis, medical history, blood pressure monitoring, and anthropometric measurements. Blood samples were collected for lipid, glucose, and C-reactive protein (CRP) analysis. Calculation and classification of cardiovascular risk were done according to the summation score and the 30-year Framingham score. The test t was used to compare scores between different APOs, with a p-value < 0.05 considered significant.

Results: We selected 125 women aged 30 ± 6 years and found an hospital prevalence of APO equal to 17.8%. High hs-CRP (85.6%), dyslipidemia (49.2%), obesity/overweight (41.6%) and arterial hypertension (22.4%) were identified as cardiovascular risks. According to the summation method, overall cardiovascular risk was high (≥ 3 risk factors) in 21.5% of women. Applying the 30-year Framingham score the risk was moderate in 27.2%. This risk was even greater in the presence of hypertensive pregnancy disorder (10,4±0,7 vs 6,6±0,7; p=0,001) or low birth weight (18,0±7,1 vs 9,0±0,5; p=0,004).

Conclusion: The study highlighted the association of cardiovascular risk factors with adverse pregnancy outcomes and estimated that the risk of cardiovascular events was either high or moderate, depending on the method used.