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- Title
Maternal Cardiovascular and Cerebrovascular Health After Placental Abruption: A Systematic Review and Meta-Analysis (CHAP-SR).
- Authors
Ananth, Cande V; Patrick, Haylea S; Ananth, Srinidhi; Zhang, Yingting; Kostis, William J; Schuster, Meike
- Abstract
Placental abruption and cardiovascular disease (CVD) have common etiological underpinnings, and there is accumulating evidence that abruption may be associated with future CVD. We estimated associations between abruption and coronary heart disease (CHD) and stroke. The meta-analysis was based on the random-effects risk ratio (RR) and 95% confidence interval (CI) as the effect measure. We conducted a bias analysis to account for abruption misclassification, selection bias, and unmeasured confounding. We included 11 cohort studies comprising 6,325,152 pregnancies, 69,759 abruptions, and 49,265 CHD and stroke cases (1967–2016). Risks of combined CVD morbidity-mortality among abruption and nonabruption groups were 16.7 and 9.3 per 1,000 births, respectively (RR = 1.76, 95% CI: 1.24, 2.50; I 2 = 94%; τ2 = 0.22). Women who suffered abruption were at 2.65-fold (95% CI: 1.55, 4.54; I 2 = 85%; τ2 = 0.36) higher risk of death related to CHD/stroke than nonfatal CHD/stroke complications (RR = 1.32, 95% CI: 0.91, 1.92; I 2 = 93%; τ2 = 0.15). Abruption was associated with higher mortality from CHD (RR = 2.64, 95% CI: 1.57, 4.44; I 2 = 76%; τ2 = 0.31) than stroke (RR = 1.70, 95% CI: 1.19, 2.42; I 2 = 40%; τ2 = 0.05). Corrections for the aforementioned biases increased these estimates. Women with pregnancies complicated by placental abruption may benefit from postpartum screening or therapeutic interventions to help mitigate CVD risks.
- Subjects
MATERNAL health services; ONLINE information services; CINAHL database; CEREBROVASCULAR disease; META-analysis; STROKE; CONFIDENCE intervals; MEDICAL databases; INFORMATION storage &; retrieval systems; ABRUPTIO placentae; SYSTEMATIC reviews; CARDIOVASCULAR system; CORONARY artery disease; DESCRIPTIVE statistics; MEDLINE
- Publication
American Journal of Epidemiology, 2021, Vol 190, Issue 12, p2718
- ISSN
0002-9262
- Publication type
Article
- DOI
10.1093/aje/kwab206