Association Between History of Adverse Pregnancy Outcomes and Coronary Artery Disease Assessed by Coronary Computed Tomography Angiography

Abstract

(JAMA. 2023;329:393–404) Some lifestyle and genetic risk factors for coronary artery disease (CAD) are common between women and men, but others affect only women, such as preeclampsia, gestational hypertension, preterm delivery, and other adverse pregnancy complications and outcomes. Each of these has been linked to an increased risk in CAD, which has long been a leading cause of death. Risk factors for CAD associated with pregnancy outcomes are often overlooked because they tend to occur in younger women who may have otherwise good cardiovascular health. One method used to analyze and diagnose risks related to CAD is coronary computed tomography (CT) angiography; it is a noninvasive technique used to visualize the coronary arteries and screen for occlusion or other markers of subclinical CAD. Previous research has been unclear about the effect of cardiovascular complications during pregnancy on overall later cardiovascular health. This study aimed to understand associations between subclinical CAD as examined by coronary CT angiography and a history of adverse pregnancy outcomes.