Abstract 13901: Elevated Cardiovascular Risk Factors among Appalachian Women with a History of Pregnancy Complications

Abstract

Introduction: A growing body of evidence links complications of pregnancy (gestational diabetes, preeclampsia, and pregnancy-induced hypertension) with double the risk of future cardiovascular disease (CVD) related death in affected women. However, little is known about which CVD risk factors are more prominent among women who have experienced pregnancy complications. Purpose: Compare the presence of modifiable CVD risk factors among women with and without a self-reported history of pregnancy complications living in Appalachian Kentucky- an area with the highest rate of CVD mortality in the U.S. Methods: Rural Kentucky Appalachian women (n = 122, 97% Caucasian, 42 ± 12 years) engaged in a comprehensive measurement of CVD risk factors including body mass index (BMI), waist circumference, blood pressure, A1C, lipid profile (total cholesterol, triglycerides, HDL, and LDL), tobacco smoke exposure (objectively measured with urine cotinine), depression (Patient Health Questionnaire-9), and anxiety (Brief Symptom Inventory). We used independent t-tests and chi-square analysis to compare risk factors between women with and without a history of pregnancy complications. Results: One-fourth of the sample had one or more pregnancy complications: gestational diabetes (8.2%), preeclampsia (6.6%) and pregnancy-induced hypertension (15.6%). Women with at least one pregnancy complication had a higher average BMI (33.4 vs. 30.4, p = .014), larger waist circumference (42.8 vs. 39.1 cm, p = .006), and a higher proportion with moderate to severe symptoms of depression (27.6% vs. 15.9%, p = .02) compared to women without a history of pregnancy complications. There were no differences between groups in systolic or diastolic blood pressure, A1C levels, lipid profiles, tobacco smoke exposure, or anxiety. Conclusions: Women with a history of pregnancy complications have several modifiable risk factors- higher BMI, higher waist circumference, and higher levels of depression- that could constitute a link between past pregnancy complications and their risk of future CVD death. Pinpointing which modifiable risk factors are elevated in these women will help us develop self-management interventions to prevent the development of CVD in this high-risk population.