Is placental abruption linked to future cardiovascular disease?
Dr Lissette Sanchez-Aranguren
Accumulating data support the answer is yes. A recent meta-analysis of 11 cohort studies including over 6 million pregnancies, nearly 70,000 abruptions, and nearly 50,000 cases of cardiovascular disease (stroke and coronary heart disease) explored the future risk to develop cardiovascular conditions. Results highlight a positive association between patients experiencing placental abruption and higher risk for cardiovascular disease (1,2).
The study by Ananth et al. (2021) published in the American Journal of Epidemiology, estimated significant associations between abruption and coronary heart disease and stroke. As the authors report “Risks of combined cardiovascular disease morbidity-mortality among abruption and non-abruption groups were 16.7 and 9.3 per 1,000 births, respectively (RR = 1.76, 95% CI: 1.24, 2.50; I2 = 94%;τ2 = 0.22)”. These results suggest that women who had suffered placental abruption may have a 2.7-fold increased risk of stroke and/or coronary heart disease. When going into detail, the authors were able to identify that these associations did not discriminate as to whether women were more prone to die from these conditions or to suffer from their complications. However, it was reported that placental abruption was associated with higher risk of mortality from coronary heart disease than stroke (1).
Similar to Ananth et al. (2021) observations from DesJardin et al. (2020) reported in the American Journal of Cardiology showed that among 1.5 million pregnancies monitored, 1% of the patients presented with placental abruption. In this report, the authors were able to identify a high risk for developing heart failure in those patients experiencing placental abruption within 4.87 years of the event. However, they were not able to associate to higher risk for stroke (2).
Although both studies show similarities as to placental abruption is linked to higher risk of cardiovascular disease, it is not clear how long after the events these complications and/or mortality increased risk will manifest. Therefore, women presenting complications in pregnancy may benefit from postpartum screening involving several years of follow-up exploration to help mitigating the increased risk from cardiovascular disorders.
References:
- Cande V Ananth, Haylea S Patrick, Srinidhi Ananth, Yingting Zhang, William J Kostis, Meike Schuster, Maternal Cardiovascular and Cerebrovascular Health After Placental Abruption: A Systematic Review and Meta-Analysis (CHAP-SR), American Journal of Epidemiology, Volume 190, Issue 12, December 2021, Pages 2718–2729, https://doi.org/10.1093/aje/kwab206
- Jacqueline T. DesJardin, Michael J. Healy, Gregory Nah, Eric Vittinghoff, Anushree Agarwal, Gregory M. Marcus, Juan M. Gonzalez Velez, Zian H. Tseng, Nisha I. Parikh, Placental Abruption as a Risk Factor for Heart Failure, The American Journal of Cardiology, Volume 131, 2020, Pages 17-22, ISSN 0002-9149, https://doi.org/10.1016/j.amjcard.2020.06.034.