BACKGROUND Maternal pregnancy complications, particularly preeclampsia and gestational diabetes mellitus, are described to increase the risk for subsequent coronary artery disease (CAD). In addition, black women are at higher risk for CAD. The objective of this study was to compare the prevalence and extent of CAD as detected by coronary computed tomographic angiography (CCTA) in black women with and without a history of prior pregnancy complications. METHODS We retrospectively evaluated patient characteristics and CCTA findings in groups of black women with a prior history of preterm delivery (n=154), preeclampsia (n=137), or gestational diabetes mellitus (n=148), and a matched control group of black women who gave birth without such complications (n=445). Univariate and multivariate analyses were performed to assess risk factors of CAD. RESULTS All groups with prior pregnancy complications showed higher rates of any (≥20% luminal narrowing) and obstructive (≥50% luminal narrowing) CAD (preterm delivery: 29.2% and 9.1%; preeclampsia: 29.2% and 7.3%; and gestational diabetes mellitus: 47.3% and 15.5%) compared with control women (23.8% and 5.4%). After accounting for confounding factors at multivariate analysis, gestational diabetes mellitus remained a strong risk factor of any (odds ratio, 3.26; 95% CI, 2.03-5.22; P<0.001) and obstructive CAD (odds ratio, 3.00; 95% CI, 1.55-5.80; P<0.001) on CCTA. CONCLUSIONS Black women with a history of pregnancy complications, particularly gestational diabetes mellitus, have a higher prevalence of CAD on CCTA while only a history of gestational diabetes mellitus was independently associated with any and obstructive CAD on CCTA.

中文翻译：

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黑人女性的冠状动脉计算机断层扫描血管造影评估的妊娠并发症与随后的冠状动脉疾病之间的关系。

背景技术描述了母体妊娠并发症，特别是先兆子痫和妊娠糖尿病，其增加了随后的冠状动脉疾病（CAD）的风险。此外，黑人女性患冠心病的风险更高。这项研究的目的是比较通过冠状动脉计算机断层血管造影术（CCTA）检测的有无先前妊娠并发症史的黑人女性的CAD患病率和程度。方法我们回顾性评估了具有早产（n = 154），先兆子痫（n = 137）或妊娠糖尿病（n = 148）的既往史的黑人妇女组的患者特征和CCTA发现，以及一个配对的对照组。出生时没有这种并发症的黑人妇女（n = 445）。进行单因素和多因素分析以评估CAD的危险因素。结果所有先前有妊娠并发症的组均显示较高的房颤（≥20％腔狭窄）和阻塞性（≥50％腔狭窄）CAD（早产：29.2％和9.1％;子痫前期：29.2％和7.3％;妊娠糖尿病）相比之下，女性分别为47.3％和15.5％）（分别为23.8％和5.4％）。在多因素分析中考虑了混杂因素后，妊娠糖尿病仍然是任何危险因素（比值比为3.26； 95％CI为2.03-5.22； P <0.001）和阻塞性CAD（比值比为3.00； 95％CI）为危险因素。 1.55-5.80； P <0.001）。结论具有妊娠并发症史的黑人妇女，特别是妊娠糖尿病，在CCTA上的CAD患病率较高，而只有妊娠糖尿病史与CCTA上的任何阻塞性CAD独立相关。