Adverse Pregnancy Outcomes and Maternal Chronic Diseases in the Future: a Cross-sectional Study Using KoGES-HEXA Data

Abstract Purpose Adverse pregnancy outcomes (APOs) are associated with an increased risk of chronic diseases, including cardiovascular disease (CVD) and metabolic syndrome (MS), in the future. We designed a large-scale cohort study to evaluate the influence of APOs (preeclampsia, gestational diabetes mellitus [GDM], stillbirth, macrosomia, and low birth weight) on the incidence of chronic diseases, body measurements, and serum biochemistry in the future and investigate whether combinations of APOs had additive effects on chronic diseases.Methods We used health examinee data from the Korean Genome and Epidemiology Study (KoGES-HEXA) and extracted data of parous women (n = 30,174; mean age, 53.02 years) for the analysis. A logistic regression model was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals.Results The prevalence rate of APOs was 17.4% (5,264 women). Univariate analysis revealed that women with APOs were more frequently diagnosed with chronic diseases and had a family history of chronic diseases compared with women without APOs. In logistic regression analysis, composite APOs were associated with an increased risk of hypertension, diabetes mellitus, hyperlipidemia, angina pectoris, stroke, and MS (aOR: 1.093, 1.379, 1.269, 1.351, 1.414, and 1.104, respectively), after adjustment for family history and social behaviors. Preeclampsia and GDM were associated with an increased risk of some chronic diseases; however, the combination of preeclampsia and GDM did not have an additive effect on the risk.Conclusion APOs moderately influenced the future development of maternal CVD and metabolic derangements, independent of family history and social behaviors.