Cardiovascular risk factors in women with inheritable thrombophilia a decade after single or recurrent hypertensive disorder of pregnancy

Figures & data

Table 1. Characteristics of study population at screening visit.

	Recurrent HD (n = 11)	Single HD (n = 11)		p-Value
Age (years)	44.5 ± 3.6		44.7 ± 4.2	0.91
Non-Caucasian	1 (9.1)		0 (0)	1.00
Years since delivery in FRUIT-RCT	9.1 ± 2.7		10.0 ± 3.3	0.49
Current smoker	0 (0)		2 (18.2)	0.48
Family history of vascular disease^a
First degree family (parents or siblings): arterial	3/10 (30)		3 (27.3)	1.00
First degree family (parents or siblings): venous	2/10 (20.0)		4/10 (40)	0.81
Mother and/or sister HD	6 (54.5)		2 (18.2)	0.18
Thrombophilia disorder^b
Protein S deficiency	1 (9.1)		1 (9.1)	1.00
Protein C deficiency	3 (27.3)		1 (9.1)	0.59
Factor V Leiden	8 (72.7)		5 (45.5)	0.39
Prothrombin gene G20210A mutation	1 (9.1)		4 (36.4)	0.31

Data are depicted as mean ± SD or numbers (%). HD, hypertensive disorders of pregnancy.

^aSome women did not know their family history.

^bSome women were diagnosed with more than one thrombophilia disorder, thrombophilia was diagnosed before inclusion of the FRUIT-RCT and >10 weeks after (index) pregnancy.

Table 2. Obstetric history in women with recurrent and single HD in index and study pregnancy of the FRUIT-RCT.

	Recurrent HD (n = 11)	Single HD (n = 11)	p-Value
Index pregnancy
SGA infant index pregnancy	5 (45.5)	5 (45.5)	1.00
GA delivery index pregnancy (days)	207 [196–219]	205 [197–219]	1.00
Study pregnancy
Chronic hypertension at start of pregnancy	4 (36.4)	3 (27.3)	1.00
Treatment with LMWH and aspirin	7 (63.6)	6 (54.5)	1.00
Treatment with aspirin only	4 (36.4)	5 (45.5)	1.00
SGA infant study pregnancy	2 (18.2)	2 (18.2)	1.00
GA delivery study pregnancy (days)	261 [238–276]	276 [260–281]	0.24

Data are depicted as numbers (%) or median [IQR]. HD, hypertensive disorders of pregnancy; SGA, small-for-gestational-age; GA, gestational age; LMWH, lowmolecular-weight heparin.

Table 3a–c. Cardiovascular risk factors after recurrent and single HD: (a) physical examination, (b) biochemical results, (c) clinical diagnoses.

		Recurrent HD (n = 11)	Single HD (n = 11)	Total group (n = 22)	p-Value	RR (CI)
a: Cardiovascular risk factors at follow-up: physical examination
Body composition
Body mass index (kg/m^2)		27.0 ± 5.1	25.7 ± 4.3	26.3 ± 4.7	0.52	NA
Waist circumference (cm)		84.5 ± 11.5	84.9 ± 11.0	84.7 ± 11.0	0.93	NA
Hip circumference (cm)		107.5 ± 9.8	107.0 ± 8.0	107.2 ± 8.7	0.91	NA
Waist-to-hip ratio		0.78 ± 0.1	0.79 ± 0.1	0.79 ± 0.1	0.79	NA
Blood pressure
Antihypertensive medication use		3 (27.3)	1 (9.1)	4 (18.2)	0.59		1.7 (0.8–3.6)
Systolic blood pressure (mmHg)		133.2 ± 16.5	117.8 ± 17.4	125.5 ± 18.3	0.046	NA
Diastolic blood pressure (mmHg)		87.7 ± 6.1	78.1 ± 11.7	82.9 ± 10.4	0.029	NA
b: Cardiovascular risk factors at follow-up: biochemical results
Lipids
Total cholesterol (mmol/L)		4.81 ± 0.68	5.06 ± 1.22	4.94 ± 0.97	0.55		NA
HDL (mmol/L)		1.48 ± 0.39	1.55 ± 0.38	1.52 ± 0.38	0.67		NA
Triglycerides (mmol/L)		1.25 ± 0.50	1.17 ± 0.80	1.21 ± 0.65	0.80		NA
Glucose metabolism							NA
Fasting blood glucose (mmol/L)		5.36 ± 0.44	5.29 ± 0.43	5.33 ± 0.43	0.70		NA
Insulin (pmol/L)		67.82 ± 24.63	82.27 ± 83.11	75.05 ± 11.92	0.59		NA
HOMA score		16.36 ± 6.75	20.35 ± 22.3	18.35 ± 16.21	0.58		NA
Inflammation							NA
hs-CRP (mg/L)		1.21 [0.51–3.83]	0.95 [0.46–2.03]	0.97 [0.50–2.30]	0.56		NA
Renal function							NA
Creatinine (µmol/L)		75.82 ± 15.73	75.36 ± 7.13	75.59 ± 60.27	0.93		NA
eGFR (mL/min/1.73 m)		88.0 [70.0–90.0]	86.0 [76.0–89.0]	86.5 [75.5–90.0]	0.65		NA
Ureum (mmol/L)		4.91 ± 1.13	5.15 ± 1.19	5.03 ± 1.14	0.64		NA
Albumin:creatinine ratio		1.06 [0.66–4.80]	0.37 [0.27–0.56]	0.58 [0.32–1.13]	0.008		NA
3c: Cardiovascular risk factors at follow-up: clinical diagnoses
Hypertension	7 (63.6)		3 (27.3)	10 (45.5)	0.09		2.1 (0.9–5.2)
Hypercholesterolemia	3 (27.3)		5 (45.5)	8 (36.4)	0.66		0.7 (0.2–1.8)
Body mass index > 25 (kg/m^2)	6 (54.5)		5 (45.5)	11 (50)	0.67		1.2 (0.5–2.8)
Diabetes mellitus	0 (0)		0 (0)	0 (0)	–		NA
Increased cardiovascular risk	8 (72.7)		8 (72.7)	16 (72.7)	1.00		1.0 (0.4–2.6)
Metabolic syndrome	4 (36.4)		3 (27.3)	7 (31.8)	1.00		1.2 (0.5–2.8)

Data are depicted as mean ± SD, numbers (%) or median [IQR]. HD hypertensive disorders of pregnancy; RR, relative risk; CI, confidence interval; NA, not applicable; hs-CRP, high-sensitivity c-reactive protein; eGFR, estimated glomerular filtration rate. Increased cardiovascular risk is defined as presence of either of hypertension, hypercholesterolemia, BMI > 25, or DM.

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