Title

Racial Differences in Nontraditional Risk Factors Associated with Cardiovascular Conditions in Pregnancy Among U.S. Women Veterans

UMMS Affiliation

Department of Population and Quantitative Health Sciences

Publication Date

2022-01-20

Document Type

Article

Disciplines

Cardiovascular Diseases | Epidemiology | Female Urogenital Diseases and Pregnancy Complications | Health Services Research | Military and Veterans Studies | Race and Ethnicity | Women's Health

Abstract

Background: Pregnancy-related cardiovascular (CV) conditions are important predictors of future cardiovascular disease (CVD). Nontraditional factors, such as depression and chronic stress, have been associated with CVD, but their role in pregnancy-related CVD conditions (pCVD) remains unknown. To determine the association between nontraditional factors and CV conditions in pregnancy, and to explore if this risk varies by race.

Methods: Using data from a prospective study of pregnant women within the veterans affairs health system (COMFORT study), we described the prevalence of nontraditional factors (e.g., depression, post-traumatic stress disorder [PTSD], chronic stress) and used logistic regression to determine the association between nontraditional factors and pregnancy-related CV conditions (pre-eclampsia/eclampsia, gestational hypertension, gestation diabetes, or preterm delivery). Analyses were then stratified by race.

Results: Among 706 enrollees, 26% had pregnancy-related CV conditions. These women had significantly higher rates of depression (62% vs. 45%, p < 0.01), anxiety (50% vs. 37%, p = 0.01), PTSD (44% vs. 29%, p < 0.01), and high stress levels before pregnancy (22% vs. 16%, p = 0.05) compared with women with normal pregnancies. Overall, these factors were not associated with increased adjusted odds of pCVD. Overall, Black women had disproportionately higher rates of prepregnancy hypertension compared with White women (22% vs. 6%, p < 0.01).

Conclusion: Women Veterans with pCVD are a high-risk group for future CVD, with disproportionately high rates of depression, anxiety, PTSD, and chronic stress. Racial disparities exist in pregnancy-related CV risk factors, which may further compound existing racial disparities in CVD among women Veterans.

Keywords

Veterans, cardiovascular disease, disparities, pregnancy, risk factors, women's health

DOI of Published Version

10.1089/jwh.2021.0078

Source

Lumsden RH, Goldstein KM, Shephard-Banigan M, Kroll-Desrosiers A, Bean-Mayberry B, Farmer MM, Mattocks KM. Racial Differences in Nontraditional Risk Factors Associated with Cardiovascular Conditions in Pregnancy Among U.S. Women Veterans. J Womens Health (Larchmt). 2022 Jan 20. doi: 10.1089/jwh.2021.0078. Epub ahead of print. PMID: 35072546. Link to article on publisher's site

Journal/Book/Conference Title

Journal of women's health (2002)

PubMed ID

35072546

Related Resources

Link to Article in PubMed

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